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Medical Disclaimer

The information on this page is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment.

Always seek the advice of your doctor or other qualified health professional with any questions you may have regarding a medical condition.

🚨Emergency? If you have severe symptoms, difficulty breathing, or think it's an emergency, call 000 immediately.

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Bones & Joints

Information about fractures, arthritis, joint replacements, and bone injuries

Conditions: 193

Shoulder

AC Joint Injuries in Athletes

AC joint separation (shoulder separation) occurs when ligaments connecting collarbone to shoulder blade tear, graded Type I-VI by Rockwood classification - most common in contact sports and cycling falls

Sharp pain at top of shoulder where collarbone meets shoulder blade (AC joint)Visible bump or step deformity at top of shoulder (collarbone sticking up) - more prominent in higher grade injuriesPain worse with overhead activities, cross-body movements (reaching across chest), lifting, or sleeping on affected side

Separated Shoulder (AC Joint Injury)

An AC joint separation is a common shoulder injury where the collarbone becomes partially or completely separated from the shoulder blade. Learn about the different grades of injury, treatment options from rest to surgery, and what to expect during recovery.

Pain at the top of shoulderVisible bump on top of shoulderSwelling and bruising

Shoulder Dislocation and Instability

Shoulder instability causes your shoulder to slip out of place or feel like it's giving way. Learn about dislocations, Bankart lesions, arthroscopic surgery, recurrence rates, and return to sport.

Shoulder popping out of place (dislocation)Feeling of shoulder 'giving way' or slippingPain with overhead activities

Bankart Lesion (Shoulder Labrum Tear)

A Bankart lesion is a tear of the shoulder labrum (cartilage rim) that occurs with shoulder dislocations. Learn about symptoms, when surgery is needed, arthroscopic repair, and return to sport.

Shoulder instability or feeling like shoulder will dislocatePain with overhead activitiesClicking or catching sensation

Biceps Tendon Problems (Shoulder)

Biceps tendon inflammation, fraying or tears cause front shoulder pain - common in overhead athletes and middle-aged adults, treatment ranges from rest to surgical tenotomy or tenodesis

Front shoulder pain worse with overhead activities or liftingDeep aching pain in shoulder at rest, worse at nightClicking or popping sensation in front of shoulder

Brachial Plexus Birth Injury (Erb's Palsy)

Nerve injury to baby's arm during difficult delivery causing weakness or paralysis - most recover with physiotherapy by age 2, severe cases may need nerve surgery or tendon transfers

Baby's arm limp and motionless after birth (hangs at side, cannot lift arm)Waiter's tip posture (arm rotated inward, elbow straight, wrist flexed - Erb's palsy)Claw hand (fingers curled, cannot straighten - Klumpke's palsy affecting lower nerve roots)

Broken Collarbone (Clavicle Fracture)

Collarbone fractures are very common injuries from falls or sports. Learn about sling vs surgery, when you need an operation, healing time, and return to activities.

Immediate severe pain in shoulder/collarbone areaVisible bump or deformityCannot lift arm

Shoulder Impingement (Subacromial Pain)

Shoulder impingement, also called subacromial impingement, occurs when the rotator cuff tendons in your shoulder get pinched and irritated under the acromion bone (roof of your shoulder)—usually from bone spurs, thickened ligaments, or repetitive overhead activities—causing pain when lifting your arm to the side (especially between 60-120 degrees) and often worse at night. Most people (70-80%) improve with 3-6 months of physiotherapy and occasional corticosteroid injections, but if conservative treatment fails, keyhole surgery to shave the bone spur and create more space (subacromial decompression) has 85-90% success rates for relieving pain.

Pain when lifting arm to the side, especially between 60-120 degrees (painful arc)Pain reaching overhead or behind back (e.g., putting on jacket, reaching back seat)Night pain, especially lying on affected shoulder

Broken Shoulder Socket (Glenoid Fracture)

Glenoid fractures are rare but serious breaks in your shoulder socket (the concave part of the shoulder blade that the ball of your arm bone sits in), almost always from high-energy trauma like motor vehicle accidents, falls from height, or severe sports injuries—often occurring together with shoulder dislocation. Most minimally displaced fractures heal well with sling immobilization for 3-4 weeks followed by physiotherapy, but significantly displaced fractures (especially those affecting the joint surface or causing shoulder instability) require surgery to realign and fix the bone with plates and screws, followed by 4-6 months recovery with risk of permanent shoulder stiffness and post-traumatic arthritis affecting 30-40% of patients.

Severe shoulder pain after high-energy traumaInability to move shoulder or armSwelling and bruising around shoulder and shoulder blade

Internal Shoulder Impingement

Internal shoulder impingement causes pain in throwing athletes when the rotator cuff and labrum rub together with the arm overhead. Learn about symptoms, GIRD, physiotherapy, and surgical options.

Pain in back of shoulder when throwingPain with overhead activitiesLoss of throwing velocity or control

Proximal Biceps Tendon Rupture (Popeye Deformity)

Proximal biceps tendon rupture is a complete tear of the long head of the biceps tendon at the shoulder, causing sudden anterior shoulder pain (often described as a 'pop'), immediate weakness, and a characteristic distal bulge of the biceps muscle in the upper arm known as the 'Popeye deformity' or 'Popeye sign' from the muscle retracting distally when the proximal anchor is lost. The long head of biceps (LHB) tendon originates from the superior labrum inside the shoulder joint, travels through the bicipital groove of the humerus, and joins the short head to form the biceps muscle belly—when the LHB ruptures proximally (95% of biceps ruptures, vs 5% distal biceps), the muscle retracts down the arm creating the visible bulge. Risk factors include age over 40 years, chronic biceps tendinopathy, rotator cuff tears (50-60% association), corticosteroid injections, smoking, and overhead activities. Despite dramatic appearance, functional loss is surprisingly mild (10-20% loss of supination strength, 5-10% loss of elbow flexion strength) because the short head of biceps remains intact and compensates. Treatment options include conservative management (acceptable for sedentary individuals and elderly patients—90% satisfactory outcomes despite cosmetic deformity), biceps tenotomy (simple release allowing further retraction—quick recovery but persistent cosmetic deformity and 10-20% risk of muscle cramping), or biceps tenodesis (reattaching tendon to humerus restoring length-tension relationship—best cosmetic and functional outcomes 85-95% but longer recovery 4-6 months and higher complication rate 10-15%).

Sudden sharp anterior shoulder pain often described as a 'pop' or tearing sensation during lifting, overhead activity, or eccentric loading (lowering heavy weight)Visible distal bulge of biceps muscle in upper arm (Popeye deformity—muscle bunches up distally when proximal attachment lost)Immediate weakness with supination (palm-up rotation) and elbow flexion (bending elbow), though surprisingly mild 10-20% loss because short head compensates

Shoulder Fractures (Proximal Humerus Fractures)

Proximal humerus fractures are breaks in the upper arm bone near the shoulder joint, most commonly occurring in elderly people after falls due to osteoporosis - they cause severe shoulder pain, swelling, bruising, and inability to move the arm, with treatment ranging from sling immobilization for simple fractures (80-85% of cases healing well conservatively in 6-12 weeks) to surgical fixation with plates or shoulder replacement for displaced or unstable fractures.

Severe shoulder pain immediately after fall or injuryExtensive bruising tracking down arm and chest (appears 24-48 hours after injury—dramatic purple-blue discoloration)Swelling around shoulder

Reverse Hill-Sachs Lesion (Posterior Shoulder Dislocation Injury)

A reverse Hill-Sachs lesion is a dent or compression fracture in the front of the humeral head (shoulder ball) caused by posterior shoulder dislocation, where the shoulder ball jams against the back of the socket creating a permanent divot - it's much less common than regular Hill-Sachs lesions (from anterior dislocations) and may cause recurrent posterior instability requiring surgical repair if the defect involves more than 25% of the joint surface.

History of posterior shoulder dislocation (often from seizure, electric shock, or high-energy trauma)Recurrent feeling of shoulder slipping or subluxing toward back (posterior instability)Pain and weakness with arm across body (reaching across chest) or in push-up position

Reverse Shoulder Replacement (Reverse Total Shoulder Arthroplasty)

Reverse shoulder replacement is a specialized joint replacement surgery where the ball and socket of the shoulder are switched from their normal positions, designed for patients with severe rotator cuff tears and arthritis (cuff tear arthropathy) or complex fractures in elderly patients - the reversed design allows the deltoid muscle to lift the arm instead of the torn rotator cuff, providing excellent pain relief (90-95% success) and functional improvement in patients over 65 years old.

Severe shoulder pain, especially at night, not relieved by medications or injectionsInability to lift arm above shoulder level (pseudoparalysis - shoulder feels weak and won't lift)Shoulder weakness despite full passive range of motion (someone else can move your arm, but you can't lift it yourself)

Rotator Cuff Tear Arthropathy (Cuff Arthropathy)

Rotator cuff tear arthropathy is a severe shoulder condition where a long-standing massive rotator cuff tear causes the shoulder ball to migrate upward and develop arthritis from rubbing against the acromion bone, resulting in severe pain, inability to lift the arm (pseudoparalysis), and shoulder weakness - it occurs in about 4-20% of patients with massive chronic rotator cuff tears and typically requires reverse shoulder replacement surgery for pain relief and functional improvement.

Severe shoulder pain, especially at night, limiting sleep and daily activitiesInability to actively lift arm above shoulder level despite trying (pseudoparalysis)Shoulder weakness and feeling of shoulder 'giving way' with lifting attempts

Massive Rotator Cuff Tears

Massive rotator cuff tears involve two or more complete tendon tears (or one very large tear more than 5cm), causing significant shoulder weakness, difficulty lifting the arm overhead, and night pain - they occur in about 10-40% of all rotator cuff tears and are more challenging to repair, with treatment options ranging from physiotherapy and partial repairs to reverse shoulder replacement depending on age, activity level, and muscle quality.

Severe shoulder weakness, difficulty or inability to lift arm above shoulder levelNight pain disrupting sleep, especially when lying on affected shoulderPain with overhead activities (washing hair, reaching cupboards, throwing)

Rotator Cuff Tears

A rotator cuff tear happens when the tendons connecting your shoulder muscles to bone are damaged. Learn about symptoms, when surgery is needed, and how to manage shoulder pain.

Shoulder pain, especially at nightPain when lifting or lowering your armWeakness when lifting or rotating arm

Scapula Fractures (Shoulder Blade Fracture)

Scapula fractures are breaks in the shoulder blade bone, rare injuries accounting for only 1% of all fractures, typically caused by high-energy trauma (car accidents, motorcycle crashes, falls from height) - most scapula body and spine fractures (85-90%) heal well with sling immobilization and physiotherapy, while displaced glenoid (shoulder socket) fractures or severely displaced body fractures may require surgical fixation.

Severe shoulder and upper back pain immediately after high-energy traumaDifficulty moving shoulder, unable to lift arm due to painSwelling and bruising over shoulder blade area

Scapular Dyskinesis (Abnormal Shoulder Blade Movement)

Scapular dyskinesis is abnormal movement or positioning of the shoulder blade (scapula) during arm motion, causing visible winging, shoulder pain, and reduced athletic performance - it affects 60-100% of athletes with shoulder injuries and results from muscle imbalances, poor posture, or nerve injuries, with treatment focused on physiotherapy targeting scapular stabilizing muscles achieving 70-90% improvement in 3-6 months.

Visible prominence or winging of shoulder blade during arm movementsShoulder pain, especially with overhead activities (reaching, throwing)Reduced athletic performance or throwing velocity

Shoulder Arthrodesis (Shoulder Fusion Surgery)

Shoulder arthrodesis is a salvage surgery that permanently fuses the shoulder joint to eliminate pain when all other treatment options have failed - it's reserved for severe end-stage shoulder problems like failed shoulder replacements with massive bone loss, irreparable rotator cuff tears causing pseudoparalysis in young patients, or chronic shoulder infections, achieving 80-90% pain relief but eliminating shoulder movement and forcing reliance on scapular (shoulder blade) motion for arm positioning.

Severe chronic shoulder pain uncontrolled by medicationsComplete loss of shoulder function (pseudoparalysis - cannot lift arm)Previous failed shoulder surgery or infection causing ongoing problems

Shoulder Replacement Complications

Shoulder replacement surgery complications occur in 5-15% of cases and include instability (dislocation - most common in reverse shoulder replacements), infection requiring implant removal, glenoid component loosening, nerve injury causing weakness, and periprosthetic fractures - while most patients have excellent outcomes, recognizing complications early and seeking prompt treatment is critical for salvage and preserving shoulder function.

New onset severe shoulder pain weeks to months after shoulder replacement (possible infection or loosening)Shoulder feels unstable, clunking, or dislocated after initial good function (possible instability)Wound drainage, redness, warmth, or fever after shoulder replacement (possible infection)

Shoulder Replacement Infection

Shoulder replacement infection is a serious complication occurring in 1-2% of shoulder replacement surgeries when bacteria contaminate the implant during surgery or spread through the bloodstream later - it causes severe shoulder pain, fever, wound drainage, and redness weeks to months after surgery, requiring aggressive treatment with two-stage revision surgery (removing infected implant, treating infection for 6-12 weeks, then reimplanting new shoulder replacement) which successfully eradicates infection in 80-90% of cases.

New onset severe shoulder pain weeks to months after shoulder replacement (infection vs loosening)Fever, chills, feeling unwell systemicallyWound drainage, redness, warmth at surgical site

Dislocated Shoulder

Shoulder dislocations are very common sports injuries. Learn about emergency treatment, recurrence risk, when you need surgery, and preventing re-dislocation.

Severe shoulder painVisible deformityCannot move arm

Shoulder Fracture-Dislocations

Shoulder fracture-dislocations are complex injuries combining shoulder dislocation (ball coming out of socket) with fractures of the shoulder bones - most commonly the humeral head (ball), glenoid rim (socket edge), or greater tuberosity (bone bump where rotator cuff attaches) - these injuries occur from high-energy trauma (motor vehicle accidents, falls from height, seizures) causing severe pain, obvious deformity, and inability to move the shoulder, requiring emergency reduction in the emergency department followed by CT scan to assess fracture patterns and determine if surgery is needed to fix displaced bone fragments.

Severe shoulder pain after high-energy trauma or seizureObvious shoulder deformity (squared-off shoulder or arm held away from body)Complete inability to move shoulder

Shoulder Hemiarthroplasty (Partial Shoulder Replacement)

Shoulder hemiarthroplasty is partial shoulder replacement surgery where only the humeral head (ball) is replaced with a metal prosthesis while leaving the natural glenoid (socket) intact - it is primarily used for complex proximal humerus fractures in elderly patients and avascular necrosis of the humeral head with healthy glenoid cartilage - however, modern practice is shifting toward reverse total shoulder replacement for most indications because hemiarthroplasty outcomes are less predictable, with 30-40% developing progressive glenoid erosion and persistent pain requiring conversion to total shoulder replacement within 10 years.

Severe shoulder pain from proximal humerus fracture or avascular necrosisLoss of shoulder motion and functionNight pain disrupting sleep

Shoulder Arthritis (Glenohumeral Osteoarthritis)

Shoulder osteoarthritis (glenohumeral arthritis) is progressive wear and tear of the cartilage lining the shoulder ball and socket joint, causing deep shoulder pain, stiffness, grinding sensation with motion, and night pain disrupting sleep - it occurs from aging (primary osteoarthritis), previous injuries (post-traumatic arthritis), rotator cuff tears (cuff tear arthropathy), or avascular necrosis - treatment ranges from physiotherapy and injections for mild arthritis to shoulder replacement surgery for severe disease, with 90-95% of patients achieving excellent pain relief and improved function after total shoulder replacement.

Deep aching shoulder pain, worse with overhead activitiesNight pain disrupting sleep (lying on affected shoulder impossible)Shoulder stiffness and loss of motion (difficulty reaching overhead, behind back)

SLAP Tears (Shoulder Labrum Tear)

SLAP tears (Superior Labrum Anterior to Posterior) are tears of the cartilage rim at the top of the shoulder socket where the biceps tendon attaches - they commonly occur in overhead athletes from repetitive throwing or in older adults from degeneration, causing deep shoulder pain, clicking, and weakness with overhead activities, with treatment ranging from physiotherapy for mild degenerative tears to arthroscopic surgery for young athletes with Type II tears.

Deep aching shoulder pain that's hard to pinpointClicking, popping, or catching sensation in shoulder with movementPain and weakness with overhead activities (throwing, serving, lifting)

Foot

Accessory Navicular (Extra Bone in Foot)

An accessory navicular is an extra bone on the inside of your foot that can cause pain, especially during activity. Learn about symptoms, non-surgical treatments, and when surgery (Kidner procedure) might be needed.

Pain on inside of footVisible bony bumpRedness and swelling

Fifth Metatarsal Stress Fracture (Outside Foot Bone)

Fifth metatarsal stress fractures are overuse injuries affecting the long bone on the outside of your midfoot, particularly common in runners, dancers, and basketball players—causing gradual onset of outside foot pain that worsens with activity. The Jones fracture (break at the base of this bone where blood supply is poor) is especially problematic with high failure rates (30%) when treated non-surgically, making many athletes choose surgery with screw fixation for faster healing (6-8 weeks back to sport) versus 12-20 weeks in a boot with significant risk of not healing at all, requiring delayed surgery anyway.

Gradual onset pain on outside of midfoot, worsening over weeksSharp pain on outside of foot with push-off or runningTenderness when pressing on outside foot bone

Flat Feet in Children (Flexible Flatfoot)

Flexible flatfoot is extremely common in children (affecting up to 20% of kids), where the arch of the foot flattens when standing but reappears when standing on tiptoes or sitting—most cases are completely normal and improve naturally as the child grows, requiring no treatment at all. Only symptomatic flatfeet causing pain or difficulty with activities need intervention (usually supportive shoes or physiotherapy), and despite widespread use of custom orthotics, strong evidence shows they don't change the natural course of flexible flatfeet or prevent problems in adulthood, making them unnecessary for most children who have no pain.

Flat arch of foot when child stands (arch returns on tiptoes)Foot pain or aching after prolonged walking or sports (only in symptomatic cases)Leg or calf fatigue with activities (uncommon)

Jones Fracture (Break at Base of 5th Toe Bone)

A Jones fracture is a specific break at the base of the fifth metatarsal (the long bone connecting to your little toe), occurring 1.5-3cm from the bone end in a zone with poor blood supply, typically from twisting injury on outside of foot, sudden pivoting in basketball/football, or repeated stress in runners and dancers—causing pain, swelling, and difficulty walking on outside of foot. Jones fractures are notorious for slow healing and high nonunion rate (20-30% fail to heal with boot/cast alone) due to poor blood supply to this zone, making surgical screw fixation the preferred treatment for athletes and active individuals (90-95% union rate, return to sport 6-10 weeks), while non-surgical treatment reserved for low-demand patients willing to accept longer recovery (12-20 weeks) and risk of nonunion requiring delayed surgery.

Pain on outside of foot at base of little toeSwelling and bruising along outside border of footDifficulty walking or bearing weight on affected foot

Bunions in Children and Teens (Juvenile Hallux Valgus)

Juvenile hallux valgus is a bunion deformity (big toe angling toward second toe with bony bump on inside of foot) developing in children and adolescents (typically ages 10-15), often with strong family history and associated with flexible flatfeet or ligament laxity—causing pain, difficulty fitting shoes, and cosmetic concern. Unlike adult bunions which are progressive and degenerative, juvenile bunions often have underlying structural factors (metatarsus primus varus—inward angling of first metatarsal bone). Non-surgical management (wide shoes, avoiding heels, padding) is preferred until skeletal maturity due to high recurrence rates (30-50%) with early surgery. Surgery considered for persistent symptoms after skeletal maturity (age 14-16+ in girls, 16-18+ in boys) has better success but still higher recurrence than adult bunion surgery.

Visible bump on inside of foot at base of big toeBig toe angling toward second toePain or redness over bunion bump

Broken Metatarsal (Broken Foot Bone)

Metatarsal fractures are breaks in the long bones of your forefoot. Learn about stress fractures, Jones fractures, treatment with walking boot or surgery, and when you can walk and return to sport.

Pain in the forefootSwelling and bruisingDifficulty weight-bearing

Stress Fractures of the Foot Bones

Metatarsal stress fractures are tiny cracks in the long bones of the foot caused by repetitive impact from running, jumping, or marching - the second metatarsal is most commonly affected (called 'marching fracture' from military recruits), while fifth metatarsal base fractures (Jones fractures) are high-risk due to poor blood supply - most stress fractures heal with 6-8 weeks in a walking boot and activity modification (95%+ success), but Jones fractures often require surgery with screw fixation to prevent nonunion, especially in athletes.

Gradual onset forefoot pain, pinpoint tenderness over bone, worse with walking/runningPain improves with rest and worsens with return to activitySwelling on top of foot over affected metatarsal bone

Curved Baby Foot (Metatarsus Adductus)

Metatarsus adductus is a common pediatric foot deformity where the forefoot (toes and front part of foot) curves inward toward the midline while the heel remains in normal position—creating a 'C-shaped' or 'banana-shaped' foot appearance when viewed from the sole. This is the most common congenital foot deformity (affecting 1-2 per 1,000 births), typically noticed at birth or in the first few months of life, and thought to result from intrauterine positioning (tight space in womb). The condition ranges from flexible (foot can be passively straightened to neutral) to rigid (foot cannot be straightened), with flexibility being the key determinant of treatment and prognosis. Most mild-to-moderate flexible cases (85-90%) resolve spontaneously by 12-18 months with observation and stretching, while moderate rigid or severe deformities may require serial casting or rarely surgery (in persistent cases after age 4-5 years). Metatarsus adductus is distinguished from clubfoot (more severe, involves ankle and hindfoot) and must be differentiated from skewfoot (serpentine foot with hindfoot valgus).

Curved or 'C-shaped' appearance of baby's foot (forefoot curves inward)Prominent bump on outside of foot (base of 5th metatarsal)Heel in neutral position (unlike clubfoot where heel also affected)

Broken Midfoot Bone (Navicular Fracture)

Navicular fractures are breaks in the navicular bone—a boat-shaped bone in the midfoot (between ankle and toes) critical for foot arch stability—occurring as either acute fractures from trauma (fall, twist, or crush injury) or stress fractures from repetitive loading (common in athletes, military recruits). Acute navicular fractures present with severe midfoot pain, swelling, and inability to bear weight, often associated with other midfoot injuries. Stress fractures present with insidious pain over weeks/months, worsened by running or impact activities. Navicular fractures are concerning because of poor blood supply to central third of bone (high nonunion risk 10-30% if treated conservatively) and critical role in foot arch mechanics. Treatment depends on fracture type: undisplaced stress fractures require 6-8 weeks non-weight-bearing in boot/cast (to allow healing in poorly vascularized bone), displaced acute fractures or high-risk stress fractures require surgery (screw fixation) with 85-90% union rates when treated appropriately.

Pain on top of midfoot (where foot meets ankle)Inability to bear weight or push off with footSwelling and tenderness over navicular bone (top/inside of midfoot)

Pseudo-Jones Fracture (5th Metatarsal Avulsion)

Pseudo-Jones fractures are small chip fractures at the base of the 5th metatarsal (outside of midfoot) caused by ankle rolling inward, pulling off a piece of bone where the peroneal tendon attaches - unlike true Jones fractures which have poor healing, pseudo-Jones fractures heal well in 95% of cases with simple walking boot or stiff-soled shoe for 4-6 weeks, returning to activities in 6-8 weeks.

Pain and tenderness on outer midfoot at base of 5th metatarsal bone (about 2-3cm forward from ankle)Swelling and bruising over outside of footDifficulty bearing weight, limping

Sesamoid Fractures (Broken Bones Under Big Toe)

Sesamoid fractures are breaks in two tiny pea-sized bones embedded in the tendon under the big toe joint - they can occur from acute injury (stubbing toe, landing from jump) or as stress fractures in dancers and athletes who repetitively load the forefoot, causing pain and tenderness under the ball of the foot that worsens with push-off, with treatment usually involving 6-8 weeks of offloading in a walking boot achieving 70-80% healing, but some require surgical removal if conservative treatment fails.

Sharp pain under ball of foot directly beneath big toe jointPain worsening with push-off during walking or running (especially barefoot)Tenderness when pressing on sesamoid bone under big toe

Sesamoiditis (Inflammation of Bones Under Big Toe)

Sesamoiditis is inflammation and irritation of the sesamoid bones and surrounding tendons under the big toe joint, caused by repetitive pressure and overuse from activities like dancing, running, or wearing high heels - it causes gradual-onset forefoot pain that worsens with walking or push-off, typically responding well to conservative treatment with offloading pads, stiff-soled shoes, and activity modification achieving 80-90% pain relief within 6-8 weeks.

Gradual-onset pain under ball of foot beneath big toe (develops over weeks to months)Pain worsening with barefoot walking, push-off, or wearing high heelsTenderness when pressing directly on sesamoid bones under big toe

Tarsal Coalition (Rigid Flatfoot in Children)

Tarsal coalition is an abnormal bony, cartilaginous, or fibrous connection between two or more of the tarsal bones (foot bones) - present from birth but typically becomes painful during adolescence (ages 8-16) when the coalition ossifies and restricts foot motion - it causes rigid flatfoot, ankle pain, recurrent sprains, and muscle spasms (peroneal spasm) - conservative treatment (custom orthotics, activity modification, short-leg walking cast) provides symptom relief in 50-60% of patients, while persistent symptoms are treated with surgery to remove the coalition (resection) achieving 70-80% good outcomes in well-selected cases.

Foot and ankle pain, worse with prolonged walking or sportsRigid flatfoot (arch remains flat even standing on toes)Frequent ankle sprains or feeling of instability

Turf Toe

Turf toe is a sprain of your big toe joint, common in athletes. Learn about symptoms, treatment with rest and taping, and when surgery might be needed.

Pain at the base of the big toeSwelling around the big toe jointLimited big toe movement

Hip

Hip Socket Fracture

An acetabular fracture is a break in the socket part of your hip joint. These serious injuries usually result from high-energy trauma like car accidents. Learn about symptoms, treatment options including surgery, and what to expect during recovery.

Severe hip and groin painInability to bear weightLeg appears shortened or rotated

Hip Bone Death (Avascular Necrosis)

Avascular necrosis (AVN) is bone death from loss of blood supply to the hip. Learn about causes (steroids, alcohol), staging, core decompression surgery, and when hip replacement is needed.

Groin pain (early stage)Progressive hip pain with weight-bearingLimping

Hip Impingement (CAM-Type FAI)

Femoroacetabular impingement (FAI) causes hip and groin pain in young, active people. Learn about cam and pincer types, symptoms, hip arthroscopy surgery, and return to sport.

Groin pain with activityPain with hip flexion and twistingClicking or catching sensation

Cerebral Palsy (Orthopaedic Management)

Cerebral palsy (CP) is a permanent movement and posture disorder caused by brain injury before, during, or shortly after birth, affecting 1 in 500 Australian children (approximately 34,000 Australians living with CP). While the underlying brain injury doesn't worsen, children with CP commonly develop orthopaedic complications including hip displacement (affecting 35% of all CP children and up to 90% of non-walkers), spinal deformity (scoliosis in 20-60% depending on severity), muscle contractures limiting joint movement, and foot/ankle deformities affecting gait. In Australia, children with CP are classified by the Gross Motor Function Classification System (GMFCS levels I-V, from independent walking to complete wheelchair dependence) and undergo regular hip surveillance with X-rays every 6-12 months to detect hip subluxation early when preventive surgery is most effective. Orthopaedic treatment focuses on maintaining mobility, preventing deformity, and improving function through physiotherapy, bracing, botulinum toxin injections for spasticity, and surgery when needed—with multilevel orthopaedic surgery able to significantly improve walking patterns in selected ambulatory children, and hip reconstruction preventing painful dislocation in non-ambulatory children.

Abnormal muscle tone (stiffness, spasticity, or floppiness)Delayed motor milestones (not sitting, crawling, or walking at expected ages)Abnormal gait patterns (toe-walking, scissoring, crouching)

Hip Dysplasia in Babies (DDH)

Hip dysplasia (DDH) is when a baby's hip joint doesn't form properly. Learn about screening, early detection with ultrasound, treatment from Pavlik harness to surgery, and what to expect for your child's development.

Clicking or clunking sound from hipUneven skin folds on thighs or buttocksOne leg appears shorter

Hip Ball Fracture (Femoral Head Fracture)

Femoral head fractures are rare but serious breaks in the ball of your hip joint, almost always from high-energy trauma such as car accidents (dashboard injury when knee hits dashboard driving hip ball backward out of socket) or falls from height—typically occurring together with hip dislocation causing severe pain and inability to move the leg. These injuries require emergency treatment to relocate the hip within 6 hours, usually followed by surgery to fix broken bone fragments, but despite treatment carry high risks of complications including hip bone dying from loss of blood supply (20-30% develop avascular necrosis) and arthritis (40-50%), with many patients eventually needing hip replacement within 5-10 years.

Severe hip and thigh pain after high-energy traumaInability to move or bear weight on affected legLeg appears shortened and rotated (usually turned inward and bent)

Girdlestone Procedure (Hip Without Replacement)

Girdlestone procedure is removal of infected or failed hip replacement without inserting a new implant, leaving a false joint where scar tissue fills the space between femur and pelvis - this salvage operation is performed when infection cannot be cured with implant retention and patient is too frail/sick for complex two-stage revision, or after multiple failed revision attempts - patients walk with significant limp, leg shortening (3-5cm shorter), require walking stick or frame, but achieve pain-free mobility and eradication of infection in 70-80% of cases

Greater Trochanteric Pain Syndrome (Lateral Hip Pain)

Greater trochanteric pain syndrome (GTPS) is a common cause of lateral hip pain affecting middle-aged and older adults, particularly women - it was previously called 'trochanteric bursitis' but is now recognized as primarily gluteal tendinopathy (degeneration of gluteus medius and minimus tendons where they attach to the greater trochanter) with or without bursitis - GTPS causes pain over the outer hip bone, worse lying on the affected side at night, climbing stairs, and prolonged standing, improving with conservative treatment (activity modification, physiotherapy, corticosteroid injection) in 70-80% of patients within 3-6 months, though some cases become chronic requiring ongoing management or rarely surgery.

Pain over outer hip bone (greater trochanter), sharp or achingSevere pain lying on affected side at night (unable to sleep on that side)Pain climbing stairs, getting out of car, or standing from sitting

Bone Growing in Wrong Places (After Hip Surgery or Injury)

Heterotopic ossification (HO) is abnormal bone formation in soft tissues (muscles, tendons) where bone shouldn't normally form, most commonly occurring after hip replacement surgery (20-30% of patients), severe trauma, burns, or spinal cord injury—causing progressive joint stiffness, reduced range of motion, and sometimes pain. The bone grows over weeks to months after the triggering event. Prevention with NSAIDs (indomethacin) or single-dose radiation therapy after high-risk surgeries reduces HO by 70-80%. Established symptomatic HO can be surgically removed once mature (usually 12-18 months after onset), with 70-80% improvement in motion, though recurrence occurs in 10-20% despite preventive measures.

Progressive stiffness and loss of joint motion (develops over weeks to months)Firm, non-tender mass around jointPain with movement (if bone blocks joint)

Shallow Hip Socket in Adults (Developmental Hip Dysplasia)

Adult hip dysplasia (developmental dysplasia of the hip, DDH) is a condition where your hip socket is too shallow to properly cover the ball of your hip joint, often undiagnosed in childhood but causing groin pain, hip instability, and labral tears in young adults (typically 20s-40s), particularly active women. The shallow socket causes abnormal hip mechanics and early wear of cartilage. Young patients with mild-moderate dysplasia and minimal arthritis may benefit from joint-preserving surgery (periacetabular osteotomy, PAO) which reorients the socket to better cover the ball—delaying or preventing hip replacement for 10-20+ years in 70-80% of well-selected patients. Advanced dysplasia with established arthritis requires total hip replacement, often at younger age than typical (30s-50s), with special technical considerations.

Groin pain with activity (walking, running, climbing stairs)Clicking or catching sensation in hipLimping after prolonged activity

Hip Flexor Strain

Hip flexor strains cause pain in the front of your hip or groin with running, kicking, and lifting your knee. Learn about symptoms, rest protocols, physiotherapy exercises, and return to sport.

Pain in front of hip or groinPain with running or sprintingWeakness lifting knee

Hip Arthritis

Hip arthritis causes pain in your groin or thigh when the cartilage in your hip joint wears down. Learn about symptoms, treatment options from injections to hip replacement, and what you can do to manage your hip pain.

Groin pain that's worse with activityMorning stiffnessLimping

Hip Pointer Injury

Hip pointer is a painful bruise to the hip bone from direct impact in contact sports. Learn about symptoms, ice and rest protocols, protective padding, and return to sport timelines.

Immediate severe pain at hip bone after impactPain with movementTenderness over hip bone

IT Band Syndrome (Runner's Knee)

IT band syndrome causes pain on the outside of your knee, especially in runners and cyclists. Learn about symptoms, treatment from stretching to physiotherapy, and how to prevent this common overuse injury.

Pain on outside of kneePain worse with running downhill or stairsPain that starts after a certain distance

Hip Labral Tears (Torn Cartilage in Hip Socket)

Hip labral tear - tear in ring of cartilage (labrum) lining hip socket causing groin pain, clicking, catching, giving way. Most common in young active adults (20-40s), athletes, dancers. Often caused by femoroacetabular impingement (FAI - abnormal hip bone shape pinching labrum with movement). Symptoms: deep groin pain with sitting, walking, twisting, positive C-sign (grab front of hip with thumb and fingers forming C-shape), clicking or catching sensation. Diagnosis: MRI arthrogram (dye injection) shows tear. Treatment: conservative management (physiotherapy, activity modification) often fails for significant tears. Hip arthroscopy (keyhole surgery) repairs or trims torn labrum and corrects FAI bone abnormality. Recovery 4-6 months return to activities, 6-12 months full sport. Outcomes: 80-90% good results if FAI corrected in young active patients, poorer outcomes if degenerative tears in older patients with arthritis.

Deep groin pain (front of hip)Clicking, popping, or catching sensation in hipPain with specific positions or activities

Hip Blood Supply Problem in Children (Perthes Disease)

Legg-Calvé-Perthes disease is a childhood hip condition where blood supply to the ball of the hip joint (femoral head) is temporarily interrupted, causing the bone to die (avascular necrosis) and then slowly regenerate over 2-4 years, typically affecting children ages 4-8 years (boys 4-5 times more common than girls)—presenting with limping, hip/groin pain, and limited hip motion. The disease goes through predictable stages (necrosis, fragmentation, reossification, remodeling) with treatment focused on 'containment'—keeping the softened femoral head centered in the hip socket so it heals round rather than flat. Most children with good containment achieve satisfactory long-term hip function, though 30-40% develop hip arthritis in adulthood (usually 40s-50s), earlier than normal population.

Limping (often painless initially, then painful)Hip or groin pain (sometimes referred to knee)Thigh or knee pain without obvious knee problem

Hip Fracture (Broken Hip)

A hip fracture is a break in the thigh bone near the hip joint - a serious injury that almost always requires surgery. Learn about treatment, recovery, and what to expect after breaking your hip.

Severe hip or groin painCannot bear weight or walkShortened and externally rotated leg

Severe Pelvic Ring Injury (Open Book Pelvic Fracture)

Open book pelvic fractures are severe, life-threatening pelvic ring injuries where external rotation forces cause the pelvis to 'open like a book'—disrupting the pubic symphysis (front of pelvis) and often the sacroiliac joints or sacrum (back of pelvis), classified as APC-II or APC-III (Anterior-Posterior Compression) injuries in the Young-Burgess classification. These high-energy injuries typically result from motor vehicle accidents, pedestrian vs car collisions, or motorcycle crashes, presenting with massive pelvic instability and life-threatening hemorrhage from torn pelvic venous plexus and arterial bleeding (mortality 10-20% in severe cases despite modern trauma care). Immediate management focuses on hemorrhage control using pelvic binder application, resuscitation, and emergency pelvic stabilization (external fixator or emergent ORIF), followed by definitive surgical fixation once patient stabilized. These injuries often occur as part of polytrauma (multiple injuries) and require multidisciplinary trauma team management in specialized trauma centers, with long-term outcomes depending on associated injuries (bladder/urethral trauma, nerve injuries, blood loss) and quality of pelvic reduction and fixation.

Severe pelvic pain after high-energy traumaInability to bear weight or move legsVisible pelvic deformity or leg length discrepancy

How Osteoarthritis Develops

Patient-friendly explanation of how osteoarthritis develops - from healthy cartilage to worn joints - including what happens inside the joint, why it causes pain, and what drives disease progression

Joint pain that worsens with activity and improves with rest (early disease)Morning stiffness lasting less than 30 minutes (different from inflammatory arthritis)Joint swelling and warmth after activity (synovial inflammation)

Periprosthetic Hip Fracture

Comprehensive patient guide to fractures around hip replacements - Vancouver classification, surgery options, recovery timeline, and preventing fractures after hip replacement

Sudden severe hip or thigh pain after fallInability to weight-bear or walkVisible leg deformity or shortening

Pincer Hip Impingement (Hip Socket Over-Coverage)

Pincer FAI - hip socket (acetabulum) over-covers ball of hip joint causing pinching of labrum and cartilage with movement. More common in middle-aged athletic women (30-50s), dancers, gymnasts. Excessive socket coverage (deep socket or retroverted tilted backward) causes edge of socket to contact femoral neck with hip flexion, crushing labrum rim. Symptoms: deep groin pain with sitting/walking/sports, reduced hip flexion and internal rotation, C-sign. Diagnosis: X-rays show crossover sign (anterior wall crosses posterior wall), prominent anterior wall, lateral center-edge angle over 40 degrees. MRI arthrogram shows labral tears at anterosuperior labrum (front-top rim where pinching occurs). Treatment: activity modification and physiotherapy first 3-6 months (30-50% improve). Surgery: hip arthroscopy with acetabuloplasty (trim excessive socket rim) and labral repair. Outcomes: 75-85% good results if young (under 40) with minimal arthritis and both pincer correction + labral repair performed. Poorer outcomes (50-60%) if age over 50 or arthritis present. Often coexists with cam FAI (mixed FAI 85% of cases) requiring correction of both bone abnormalities.

Deep groin pain (front of hip)Reduced hip range of motion, especially flexion and internal rotationPain at end-range hip flexion

Proximal Hamstring Tears (High Hamstring Injury)

Proximal hamstring injuries involve tears or degeneration of the hamstring tendons where they attach to the sitting bone (ischial tuberosity) in the buttock, causing deep buttock pain, difficulty sitting, and weakness with running or bending - they occur from sudden sprinting in athletes or gradual overuse in runners, with treatment ranging from rest and physiotherapy for partial tears (70-80% successful) to surgical reattachment for complete tears or failed conservative treatment.

Deep buttock pain at the sitting bone, worse with sitting on hard surfaces, running, or bending forwardSudden 'pop' or tearing sensation in buttock during sprinting or kicking (complete tears)Bruising tracking down back of thigh (appears 24-48 hours after complete tear)

Septic Arthritis of the Hip (Hip Infection in Children)

Septic arthritis of the hip in children is a bacterial infection inside the hip joint causing severe pain, refusal to walk, and high fever - it's a pediatric orthopedic emergency requiring urgent surgical drainage within 12-24 hours to prevent permanent hip damage and avascular necrosis (death of the hip ball), with treatment involving emergency open hip washout and IV antibiotics achieving 90% excellent outcomes if treated promptly, but can cause lifelong hip problems if diagnosis delayed.

Refusal to bear weight or walk (child won't put any weight on affected leg)Severe hip or groin pain, may radiate to knee (child crying, inconsolable)High fever above 38.5°C (101.3°F)

Sickle Cell Disease and Bone Problems

Sickle cell disease causes multiple bone and joint problems due to abnormal blood cells blocking blood vessels - the most common issues are avascular necrosis (death of hip or shoulder ball from blood supply loss affecting 50% of patients by age 35), bone pain crises (acute episodes mimicking infection), and increased infection risk particularly Salmonella bone infections, requiring specialized orthopedic care including early surgery for AVN and careful perioperative management.

Hip or shoulder pain developing gradually over weeks to months (possible avascular necrosis)Acute severe bone pain with fever (vaso-occlusive crisis or bone infection)Painful swollen hands or feet in young children (hand-foot syndrome/dactylitis)

Slipped Capital Femoral Epiphysis (Hip Growth Plate Slip in Teens)

Slipped capital femoral epiphysis (SCFE) occurs when the ball of the hip (femoral head) slips backward off the growth plate during adolescence - it most commonly affects overweight teenagers aged 10-16 years during rapid growth spurts, causing hip, groin, or knee pain and limping, requiring urgent surgery within 24 hours to pin the femoral head in place and prevent catastrophic complications like avascular necrosis.

Hip or groin pain developing gradually over weeks (chronic SCFE)Knee or thigh pain without hip pain (referred pain - confuses diagnosis in 15-20%)Limping, especially after activity or sports

Upper Thigh Fractures (Subtrochanteric Fractures)

Subtrochanteric fractures are breaks in the upper thigh bone (femur) just below the hip joint - most occur in elderly people with osteoporosis from low-energy falls or in younger people from high-energy trauma (car accidents, falls from height), typically requiring surgery with a metal rod and screws (intramedullary nail) inserted down the center of the thigh bone to stabilize the fracture - recovery takes 3-6 months with gradual weight-bearing progression, though some patients develop healing complications (non-union) requiring further surgery, particularly those taking long-term bisphosphonate medications who develop atypical fractures with unique fracture patterns

Severe pain in upper thigh and hip, worsens with any leg movement or weight-bearingInability to bear weight or walk on injured legLeg appears shortened and turned outward (external rotation)

Lower Leg

Achilles Tendinopathy (Achilles Tendon Pain)

Achilles tendinopathy causes pain and stiffness in the back of your ankle, common in runners and active people. Learn about eccentric exercises, treatment options, and recovery timelines.

Pain in back of ankle or heelMorning stiffness in Achilles tendonPain after running or sports

Compartment Syndrome (Surgical Emergency)

Compartment syndrome is a surgical emergency causing severe pain and limb-threatening damage. Learn about the 5 Ps warning signs, fasciotomy surgery, and why immediate treatment is critical to save your limb.

Severe pain OUT OF PROPORTION to injuryPain with passive stretching of musclesTense, swollen compartment

Blood Clots After Orthopaedic Surgery (DVT/PE)

Deep vein thrombosis (DVT) is a blood clot forming in leg veins after surgery, while pulmonary embolism (PE) occurs when that clot breaks off and travels to lungs blocking blood flow - DVT affects 1-3% of hip/knee replacement patients despite prevention measures (was 15-30% before modern blood thinners), causing leg swelling, pain, and warmth, while PE affects 0.1-0.5% causing shortness of breath, chest pain, and can be life-threatening - prevention includes blood thinners (aspirin, rivaroxaban, enoxaparin), compression stockings, and early walking after surgery

Leg swelling (calf or entire leg swollen, tight feeling)Leg pain or tenderness (usually calf, feels like cramping or soreness)Leg warmth and redness (skin feels warm to touch, may look red or purple)

Ankle Growth Plate Fractures in Teenagers

Ankle growth plate fractures occur in the lower shin bone near the ankle in children and teenagers (ages 10-16), caused by sports injuries, falls, or twisting injuries - the growth plate is the weak point in growing bones where new bone forms - these fractures cause ankle pain, swelling, and difficulty walking - treatment ranges from casting (4-6 weeks) for simple fractures to surgery for displaced fractures, with excellent outcomes in 85-95% of cases and low risk of growth problems if treated promptly

Pain in the ankle, especially when putting weight on itSwelling and bruising around the ankleDifficulty or inability to walk on the injured leg

Shin Splints (Medial Tibial Stress Syndrome)

Medial tibial stress syndrome (MTSS), commonly known as 'shin splints,' is an overuse injury causing pain along the inside (medial) border of the shin bone (tibia), typically in the lower two-thirds of the leg, resulting from repetitive stress on the bone and surrounding muscles/tendons during running, jumping, or high-impact activities. This is one of the most common running injuries (accounting for 10-15% of all running injuries), developing from accumulated microtrauma to the periosteum (bone lining) and surrounding soft tissues when training volume or intensity increases too rapidly ('too much too soon'). MTSS presents as diffuse, aching pain along the inside shin during activity—initially only during exercise, then progressing to pain before/after exercise if not treated. It differs from stress fractures (focal point tender pain) and compartment syndrome (tight, swollen calf muscles). Treatment focuses on relative rest, addressing training errors and biomechanical factors (pronation, weak hips), with 85-90% resolution in 4-8 weeks with conservative management, though 10-15% develop stress fractures if they continue training through pain.

Pain along inside edge of shin (lower two-thirds), typically 5-10cm long areaPain during running or jumping that initially improves during warm-up, then returnsTenderness when pressing along inside shin border

Osteoid Osteoma (Benign Bone Tumor Causing Night Pain)

Benign bone tumor (non-cancerous growth) causing severe night pain relieved by aspirin or NSAIDs - small nidus (5-15mm) produces prostaglandins causing characteristic pain pattern, most common in long bones of adolescents and young adults, cured by radiofrequency ablation (95% success) or surgical excision

Severe deep aching pain, WORSE AT NIGHT and disturbing sleepPain dramatically RELIEVED by aspirin or anti-inflammatory medications (NSAIDs)Localized tenderness over bone at tumor site

High Ankle Sprains (Syndesmotic Injuries)

Syndesmotic injuries (high ankle sprains) are tears of the ligaments connecting the two lower leg bones (tibia and fibula) just above the ankle - less common than regular ankle sprains (10% of all ankle injuries) but more serious, occurring from external rotation (twisting foot outward) or hyperdorsiflexion (excessive upward bending) during sports like rugby, AFL, skiing - most require 6-12 weeks immobilization in a walking boot, though severe unstable injuries require surgery with screws or flexible fixation devices to hold the bones together while ligaments heal, with return to sport typically 3-6 months due to risk of chronic ankle instability if healing inadequate

Pain above ankle between two lower leg bones (tibia and fibula), not on sides of ankleTenderness when squeezing lower leg bones together (squeeze test)Pain with external rotation of foot (turning foot outward)

Broken Shin Bone (Tibia Fracture)

Tibial shaft fractures are breaks in the main shin bone (tibia) between the knee and ankle - they commonly result from high-energy injuries like motor vehicle accidents or sports injuries, and cause severe pain, swelling, inability to walk, and visible deformity - open fractures (bone breaking through skin) occur in 20-30% of cases due to thin soft tissue covering the shin bone - treatment depends on fracture stability: minimally displaced fractures can be treated with casting (4-6 months healing), while displaced or unstable fractures require surgery with intramedullary nail (rod down center of bone) or plate fixation achieving 85-90% union.

Severe leg pain immediately after injury, unable to bear weight or walkVisible deformity, swelling, and bruising of shinBone visible through skin if open fracture (emergency)

Knee

ACL Injuries (Anterior Cruciate Ligament Tear)

An ACL tear is a common knee injury, especially in sports. Learn about symptoms, surgical and non-surgical treatment options, recovery timelines, and return to sport.

Sudden 'pop' sound or sensation at time of injuryImmediate knee swellingSevere pain initially, then improves

ACL Reconstruction Surgery

ACL reconstruction uses tendon graft (hamstring, patellar tendon, or donor tissue) to rebuild torn ACL - success rate 85-95% but 9-12 month recovery, graft choice affects outcomes and complications

Knee instability or giving way with pivoting, cutting, or sudden direction changesUnable to return to sport after ACL tear despite physiotherapy (functional instability)Recurrent knee swelling after activity

Articular Cartilage Damage (Chondral Defects)

Damage to smooth cartilage covering joint surfaces (most commonly knee) from trauma, overuse, or osteochondritis dissecans - cartilage cannot heal naturally and leads to arthritis if untreated, treatment options include microfracture, cartilage transplant, or cell-based repair

Deep aching pain in joint, worse with activity and weight-bearingIntermittent swelling and effusion (fluid in joint) after activityCatching, locking, or 'giving way' sensation if loose cartilage fragment

Knock Knees and Bow Legs in Children

Genu varum (bow legs) and genu valgum (knock knees) are angular knee deformities in children that follow a normal developmental pattern - bow legs are normal from birth to age 2 years, knees straighten by age 2-3, then knock knees peak at age 3-4 years before gradually correcting by age 7-8 - most cases are physiological (normal development) resolving without treatment, but pathological deformities from Blount disease (abnormal growth plate causing progressive bowing), rickets (vitamin D deficiency), or skeletal disorders require treatment with observation, vitamin D supplementation, bracing, or surgery (guided growth with temporary plates or corrective osteotomy) depending on severity and underlying cause.

Bowed legs (knees apart when standing with feet together) in toddlersKnock knees (ankles apart when standing with knees together) in preschoolersLimping or lateral thrust of knee with walking (pathological deformity)

Childhood Arthritis Affecting Joints (Juvenile Idiopathic Arthritis)

Juvenile idiopathic arthritis (JIA) is a group of chronic inflammatory joint diseases affecting children under 16 years, causing joint pain, swelling, stiffness (especially morning stiffness lasting more than 30 minutes), and potential long-term joint damage if untreated. Primary management is medical (with pediatric rheumatologist using medications like methotrexate, biologics) to control inflammation and prevent joint destruction. Orthopedic surgeons become involved when medical treatment alone cannot prevent complications: joint contractures (permanent stiffness) requiring soft tissue releases, leg length discrepancies from growth disturbances requiring guided growth surgery, and severe joint destruction in adolescents/young adults requiring joint replacements (hip, knee)—typically in 10-15% of JIA patients who have poorly controlled disease despite modern medications.

Joint pain and swelling (often multiple joints affected)Morning stiffness lasting more than 30 minutesLimping or reluctance to use affected limb

Knee Fusion Surgery (Knee Arthrodesis)

Knee arthrodesis is a salvage surgery that permanently fuses (locks) your knee joint in a straight or near-straight position, creating a solid bone connection between femur (thigh bone) and tibia (shin bone), eliminating knee motion but providing pain-free, stable weight-bearing. This major procedure is reserved for situations where knee replacement is not possible or has failed multiple times—typically after severe infection requiring implant removal, multiple failed knee replacements with poor bone stock, or young patients with destroyed knees unsuitable for replacement. While it eliminates knee pain (90-95% success), it creates permanent disability requiring compensatory hip/ankle motion and assistive devices, making it a last-resort option when the alternative is amputation or permanent non-weight-bearing.

Severe, unrelenting knee pain from destroyed jointKnee instability (giving way, inability to bear weight)Chronic drainage or infection from multiple surgeries

Knee Arthritis

Knee arthritis causes pain and stiffness when the cartilage in your knee joint wears down. Learn about symptoms, treatment options, and what you can do to manage your knee pain.

Knee pain that's worse with activityMorning stiffnessSwelling of the knee

MCL Injury (Medial Collateral Ligament Sprain)

MCL injury is a sprain of the ligament on the inner side of the knee. Learn about grades of injury, non-surgical treatment versus surgery, and what to expect during recovery.

Pain on inner side of kneeSwelling on inner kneeKnee instability or giving way

Ramp Lesions (Hidden Meniscus Tears with ACL Injuries)

Meniscal ramp lesions are tears between the back of the medial meniscus (inner knee cartilage cushion) and the joint capsule - they occur in 40-60% of ACL (anterior cruciate ligament) tears but are often missed on MRI and even during knee arthroscopy if not specifically looked for - ramp lesions cause persistent knee pain, swelling, and giving way similar to ACL instability - they should be repaired during ACL reconstruction surgery using sutures to reattach the meniscus to the capsule, achieving 85-90% healing and preventing later meniscus degeneration.

Posterior knee pain (pain at back of knee), worse with squatting or kneelingPersistent swelling after ACL injury or ACL reconstructionKnee giving way or instability during pivoting movements

Meniscal Repair Surgery

Comprehensive patient guide to meniscal repair surgery for knee cartilage tears - surgical techniques, healing success rates, recovery timeline, and when repair is better than removal

Knee pain along joint line (medial or lateral)Mechanical catching or locking sensationKnee swelling (effusion)

Meniscus Anchor Tear (Meniscal Root Tear)

Meniscal root tears are complete detachments of the meniscus (cartilage cushion in the knee) from its attachment point (root) to the tibia (shin bone), most commonly affecting the posterior (back) root of the medial (inside) meniscus in patients over 50 years. These tears are biomechanically equivalent to having no meniscus at all—when the root detaches, the meniscus loses its ability to distribute load across the knee, causing stress concentration on underlying cartilage similar to total meniscectomy (complete meniscus removal). This leads to rapid cartilage degeneration and knee arthritis if untreated. Medial meniscus posterior root tears (MMPRT) typically occur from degenerative changes (age-related weakening of root attachment) or acute trauma, presenting as acute knee pain, swelling, and difficulty bearing weight—often misdiagnosed as simple meniscus tear or arthritis. MRI shows characteristic 'ghost meniscus' sign (meniscus extruded or pushed out from joint). Treatment options include conservative management (acceptable for low-demand patients but leads to arthritis progression) or surgical root repair (transtibial pull-out technique) which can slow arthritis progression and relieve pain in 70-80% of patients, though cannot reverse existing cartilage damage.

Sudden onset knee pain (often medial/inside knee) after twisting or squattingKnee swelling within 24-48 hoursDifficulty bearing weight or straightening knee fully

Meniscal Transplantation

Surgical replacement of removed meniscus cartilage with donor tissue to reduce knee pain and delay arthritis in young active patients who previously had meniscus removed

Chronic knee pain after previous meniscus removal (total meniscectomy)Knee swelling and catching with activityReduced sports and activity tolerance compared to before meniscectomy

Meniscus Tears (Torn Cartilage in Knee)

A meniscus tear is a common knee injury affecting the cartilage cushion. Learn about symptoms, when surgery is needed versus physiotherapy, and what to expect during recovery.

Pain along the knee joint lineKnee locking or catchingSwelling of the knee

Cartilage Repair Surgery (Microfracture)

Microfracture is a surgical cartilage repair technique used to treat focal articular cartilage defects (areas of damaged or missing cartilage) in weight-bearing joints—most commonly the knee, but also ankle, hip, and shoulder. The procedure involves creating tiny fractures (microfractures) in the bone beneath the cartilage defect using a sharp awl, which stimulates bone marrow stem cells to migrate into the defect and form fibrocartilage 'scar tissue' to fill the void. While not as durable as native hyaline cartilage (original smooth joint cartilage), fibrocartilage provides reasonable load distribution and pain relief in 70-80% of patients at 2-5 years post-op. Microfracture is best suited for: focal defects less than 2-4 square cm, patients under 40 years, high-activity individuals wanting to avoid or delay joint replacement, acute traumatic cartilage injuries (not degenerative arthritis). Recovery requires strict non-weight-bearing for 6-8 weeks to allow fibrocartilage to form without being crushed, making this a demanding rehab but worthwhile for carefully selected patients wanting joint preservation.

Localized joint pain (often can point to specific spot)Swelling after activityMechanical symptoms (catching, locking, grinding)

Osgood-Schlatter Disease (Growing Pains in Knee)

Osgood-Schlatter disease causes knee pain and a painful bump below the kneecap in active growing children. Learn about causes, treatment, when your child can return to sport, and whether it goes away.

Painful bump below the kneecapKnee pain with activityPain after kneeling

Osteochondral Allograft Transplantation (Fresh Donor Cartilage)

Transplant of fresh cartilage and bone from deceased donor to repair large cartilage defects - used for massive cartilage damage (more than 6-10 cm²) too large for other repairs, preserves patient's own joint and delays joint replacement by 10-15 years in young active patients

Deep persistent pain in joint, especially with weight-bearing and activitySignificant swelling and joint effusion (fluid accumulation)Mechanical symptoms - catching, locking, grinding sensation

OATS - Mosaicplasty (Transferring Your Own Cartilage Plugs)

Surgical procedure transferring cylindrical plugs of healthy cartilage and bone from non-weight-bearing area of your own knee to fill cartilage defects - for medium-sized defects 1-4 cm², better long-term results than microfracture (75-85% success at 10 years), uses your own normal hyaline cartilage

Deep aching pain in joint, worse with activity and weight-bearingIntermittent joint swelling and effusion after activityCatching or locking sensation if loose cartilage present

Knee Cartilage Damage - Osteochondral Defects (Damaged Knee Joint Surface)

Osteochondral defects in knee - damage to both cartilage AND underlying bone causing pain, swelling, catching/locking, and leading to arthritis. Common locations: patellofemoral joint (kneecap cartilage), femoral condyles (weight-bearing surfaces), trochlea (kneecap groove). Causes: acute trauma (patellar dislocation, dashboard injury, ACL injury), osteochondritis dissecans in young athletes, degenerative wear. Symptoms worse than pure cartilage damage (bone component causes bone marrow edema and chronic pain). Treatment: conservative (physiotherapy, activity modification) for small defects, or surgery (microfracture for small, OATS for medium, osteochondral allograft or ACI for large defects). Outcomes depend on size, location, age - patellofemoral defects have worse prognosis than condylar defects.

Deep knee pain with weight-bearing activities (stairs, squatting, running)Knee swelling (effusion) after activitiesMechanical symptoms (catching, clicking, locking)

Osteochondritis Dissecans (OCD) of the Knee in Children

Osteochondritis dissecans (OCD) is a condition where a segment of bone and overlying cartilage in the knee loses blood supply and can separate, creating a loose piece in the joint - it most commonly affects active children and adolescents aged 10-20 years in the thighbone just above the knee joint - juvenile OCD (in children with open growth plates) has better healing potential than adult OCD, with 50-60% healing with conservative treatment (activity restriction, protected weight-bearing for 3-6 months) - unstable or displaced fragments require surgery to drill the bone (stimulate healing) or fix the fragment back in place achieving 70-85% good outcomes.

Vague, poorly localized knee pain, worse with activity (running, jumping)Knee swelling after sports or prolonged activityKnee locking, catching, or giving way (if loose fragment present)

Bone Cancer in Children and Young Adults (Osteosarcoma)

Osteosarcoma is the most common primary bone cancer in children, adolescents, and young adults (peak age 10-20 years), typically developing in the metaphysis (growing end) of long bones—most commonly around the knee (60-70% of cases: distal femur, proximal tibia) or proximal humerus (upper arm). It presents as progressively worsening bone pain (initially mistaken for growing pains), swelling, and occasionally a palpable mass, often following minor trauma that brings attention to the area. Osteosarcoma is an aggressive malignancy that produces abnormal bone (osteoid) and requires intensive multimodality treatment: neoadjuvant chemotherapy (pre-operative chemotherapy to shrink tumor, 8-12 weeks), limb salvage surgery (removing tumor while preserving limb function with endoprosthesis or allograft reconstruction, 90-95% of cases), and adjuvant chemotherapy (post-operative chemotherapy to kill micrometastases, 6-8 months total). With modern treatment protocols, 5-year survival is 65-70% for localized disease, though metastatic disease at presentation (20% of cases, usually lung) has poorer prognosis (30-40% survival).

Bone pain that progressively worsens over weeks/months (often worse at night)Swelling or lump over affected boneLimp or reduced use of affected limb

Broken Kneecap (Patella Fracture)

Kneecap fractures usually need surgery to restore knee function. Learn about symptoms, surgery with wires or screws, recovery timeline, and when you can walk again.

Severe knee painCannot straighten knee or lift legVisible deformity or gap

Kneecap Dislocation in Children and Teens

Patellar instability in children and adolescents occurs when the kneecap (patella) slides out of position, usually to the outside of the knee - it most commonly affects teenage girls during sports involving pivoting or cutting movements - first-time dislocations are typically treated non-surgically with bracing and physiotherapy (60-70% avoid recurrence), while recurrent instability often requires surgery to reconstruct the ligament holding the kneecap in place (MPFL reconstruction) or realign knee structures, achieving 85-90% stability after surgery.

Kneecap visibly out of place to the side of knee (may pop back on its own)Severe pain and inability to straighten knee after dislocationKnee giving way or feeling unstable during activities

Jumper's Knee (Patellar Tendinitis)

Patellar tendinitis (jumper's knee) is an overuse injury causing pain at the bottom of the kneecap where the patellar tendon attaches, most commonly affecting jumping athletes (basketball, volleyball, netball players) due to repetitive stress during landing and takeoff. The condition develops from accumulated microtrauma to the tendon causing degenerative changes (tendinosis—collagen breakdown and failed healing) rather than acute inflammation, presenting as anterior knee pain that worsens with jumping, running, squatting, or stairs and is tender to touch just below the kneecap. Patellar tendinopathy progresses through stages from pain only after activity (Stage 1) to constant pain affecting sport performance (Stage 3-4), classified by the Blazina system. Treatment focuses on load management and eccentric strengthening exercises (heavy slow resistance training shown to stimulate tendon remodeling), with 70-80% achieving good results over 3-6 months of conservative management, though 10-20% develop chronic symptoms requiring surgical intervention (debridement or tendon scraping) for refractory cases not responding to 6-12 months of physiotherapy.

Pain at bottom of kneecap during or after jumping, running, stairsTenderness when pressing just below kneecap (patellar tendon)Morning stiffness in front of knee (improves with warm-up)

Patellar Tendon Tear (Complete Rupture)

Patellar tendon rupture is a complete tear of the tendon connecting the kneecap (patella) to the shin bone (tibia), causing sudden severe knee pain, inability to straighten the leg, and loss of the extensor mechanism—a devastating injury that requires emergency surgical repair to restore knee function. These ruptures typically occur during forceful eccentric quadriceps contraction (landing from a jump, sudden deceleration, stumbling down stairs) in adults 30-50 years old, often with predisposing tendon weakening from chronic patellar tendinopathy, corticosteroid use, systemic diseases (diabetes, chronic kidney disease, rheumatoid arthritis), or prior knee surgery. Clinically, patients present with inability to lift the leg straight (positive straight leg raise test), palpable gap below the kneecap, high-riding patella on X-ray (patella alta), and large hemarthrosis (blood in joint). Treatment is almost always surgical—early repair within 2 weeks critical as delayed surgery has worse outcomes due to tendon retraction, muscle shortening, and scar tissue formation. Surgical repair involves reattaching torn tendon to patella with strong sutures, augmentation with wire or suture anchors, and often requiring tissue augmentation in chronic cases (allograft, synthetic graft, hamstring autograft). Recovery timeline: 4-6 months to regain full knee function, 6-12 months to return to high-level activities, with 75-85% achieving good functional outcomes if repaired early, though many have residual quadriceps weakness (10-20% weaker than uninjured leg).

Sudden severe knee pain during jumping, landing, or sudden movementInability to straighten knee or lift leg while lying downPalpable gap below kneecap (can feel defect where tendon torn)

Kneecap Instability (Patellar Dislocation)

Patellofemoral instability is a condition where the kneecap (patella) is prone to slipping out of place (dislocating) to the outside of the knee, most commonly affecting adolescents and young adults (particularly teenage females) during pivoting or cutting activities. The first dislocation typically occurs during sports (netball, basketball, football, dance) when changing direction suddenly, causing immediate severe pain, visible deformity (kneecap displaced to outside of knee), and inability to straighten the leg—though kneecap usually reduces spontaneously or with gentle straightening. Patellofemoral instability results from combination of anatomical risk factors (shallow trochlear groove—shallow femoral groove kneecap sits in, high-riding kneecap—patella alta, increased Q-angle causing lateral pull, ligamentous laxity) and soft tissue injury to the medial patellofemoral ligament (MPFL—main restraint preventing lateral dislocation) which tears during dislocation. After first-time dislocation, recurrence risk is 15-44% overall but up to 60% in high-risk patients with anatomical abnormalities. Treatment after first dislocation: conservative management (immobilization 2-4 weeks, physiotherapy for quadriceps strengthening and VMO retraining) appropriate for 60-70% who don't have recurrent instability, versus surgical stabilization (MPFL reconstruction, tibial tubercle osteotomy, trochleoplasty) reserved for recurrent dislocators or those with major anatomical risk factors. Surgical outcomes: 85-90% success preventing recurrent dislocation after MPFL reconstruction in appropriately selected patients.

Kneecap slipping out of place to outside of knee (may reduce spontaneously)Feeling of knee 'giving way' or instability during pivoting, cutting, or sudden direction changeAnterior knee pain around kneecap (without frank dislocation—patellar subluxation)

Posterior Cruciate Ligament (PCL) Tear

Posterior cruciate ligament (PCL) injuries are tears of the thick ligament running through the center of the knee that prevents the shin bone (tibia) from sliding backward relative to the thigh bone (femur), most commonly occurring from dashboard injuries in motor vehicle accidents, falls onto a flexed knee, or hyperextension injuries in sports. Unlike ACL tears which cause dramatic instability, isolated PCL injuries often cause surprisingly mild symptoms—vague knee discomfort, difficulty with stairs or kneeling, and subtle posterior sag when examined—making them frequently missed or underdiagnosed. PCL tears are graded I-III based on severity (Grade I: partial tear with less than 5mm posterior translation, Grade II: complete tear with 5-10mm translation, Grade III: complete tear with more than 10mm translation often with associated injuries). Isolated PCL injuries (60-70% of cases) are usually managed conservatively with quadriceps-focused physiotherapy achieving 70-80% satisfactory outcomes, as the quadriceps muscle compensates for PCL insufficiency by pulling tibia forward during weight-bearing. However, combined PCL injuries with posterolateral corner (PLC), ACL, or multi-ligament knee injuries require surgical reconstruction to prevent chronic instability and arthritis. PCL reconstruction surgery is technically demanding (done arthroscopically using hamstring or Achilles allograft), with 75-85% achieving good stability but residual mild laxity common, and return to high-level sports taking 9-12 months with many athletes not returning to pre-injury performance level.

Vague knee discomfort or aching (not severe pain like ACL tears)Difficulty going down stairs or descending hillsPain with kneeling or deep squatting

Inner Knee Pain (Pes Anserine Bursitis)

Pes anserine bursitis is inflammation of the bursa (fluid-filled sac that reduces friction) located on the inner side of the knee about 5-7cm below the joint line, where three hamstring tendons (sartorius, gracilis, semitendinosus—collectively called pes anserinus meaning 'goose's foot' for their fan-like arrangement) attach to the shin bone (tibia), most commonly affecting middle-aged and older women (particularly those with obesity, osteoarthritis, or diabetes) and distance runners. The condition presents as localized tenderness and pain on the inside of the knee that worsens with stairs, prolonged sitting, or getting up from a chair, often mimicking medial meniscus tears or medial compartment arthritis but distinguished by point tenderness 5-7cm below the joint line (not at the joint line itself). Pes anserine bursitis develops from repetitive friction between the tendons and underlying bursa, exacerbated by knee valgus (knock-knee) alignment, hamstring tightness, or biomechanical overload from obesity or altered gait patterns. Diagnosis is clinical (point tenderness at pes anserine insertion site) with imaging rarely needed unless excluding other pathology. Treatment is almost always conservative: activity modification, ice, NSAIDs, physiotherapy for hamstring stretching and strengthening, addressing underlying biomechanics (orthotics, weight loss), with 80-90% achieving resolution in 4-8 weeks. Corticosteroid injections provide rapid relief if conservative management fails (85-90% success rate), with surgery rarely needed (excision of bursa only if chronic refractory cases not responding to 6-12 months of conservative treatment and injections).

Pain on inside of knee 5-7cm below joint line (not at joint line)Tenderness when pressing on inner shin bone below kneePain worsening with stairs (especially going up)

Posterolateral Corner Injuries (PLC - Outer Knee Ligaments)

Outer knee stabilizers (LCL, popliteus, popliteofibular ligament) torn from high-energy trauma - dial test diagnostic, nearly always combined with ACL/PCL tears, missed injury causes ACL graft failure 30-50%

Lateral (outer) knee pain and instability after high-energy injury (feels like knee buckling outward)Knee hyperextension or varus gapping (outer knee opens up abnormally when weight-bearing)Common peroneal nerve injury symptoms (foot drop, numbness over dorsum of foot - nerve runs through PLC, injured 15-30% cases)

Knee Growth Plate Injuries in Children (Proximal Tibia)

Proximal tibial physeal injuries are fractures through the growth plate at the top of the shin bone just below the knee in children and adolescents - these are rare but serious injuries (risk of blood vessel damage and leg growth disturbance) typically caused by high-energy trauma like motor vehicle accidents or sports collisions, requiring urgent assessment for arterial injury and usually needing surgical fixation to prevent growth deformity.

Severe knee and upper shin pain after high-energy injury (MVA, sports collision)Knee swelling and deformity, inability to bear weightFoot cold, pale, or numb (warning sign of arterial injury—surgical emergency)

Proximal Fibula Dislocation (Knee Joint)

Proximal tibiofibular joint dislocation is a rare injury where the small fibula bone at the outer knee pops out of its joint with the tibia (shin bone), typically from sports trauma or falls causing twisting force - it causes lateral knee pain, visible bump below knee, and occasionally foot drop from nerve injury, with treatment ranging from closed reduction and immobilization (most cases healing well in 4-6 weeks) to surgical fixation for unstable or recurrent dislocations.

Sharp lateral (outer) knee pain just below the joint lineVisible or palpable bump on outer side of knee (dislocated fibula head)Foot drop or numbness over top of foot (common peroneal nerve injury occurs 10-20% of cases)

Segond Fracture (Knee Bone Chip with ACL Tear)

A Segond fracture is a small chip of bone pulled off the outer edge of the tibia (shin bone) near the knee joint, occurring when the anterolateral ligament tears during a twisting knee injury - this tiny fracture fragment is a 'red flag' sign that nearly always (95-100%) indicates a serious ACL (anterior cruciate ligament) tear, with treatment focused on reconstructing the torn ACL rather than fixing the small bone chip which heals on its own.

Immediate severe knee pain after twisting injury (pivoting, landing from jump)Rapid knee swelling within 1-2 hours (blood filling the joint from ACL tear)Feeling of knee instability or giving way when trying to walk

Septic Arthritis (Joint Infection in Adults)

Septic arthritis is a bacterial infection inside a joint causing severe pain, swelling, fever, and inability to move the joint - it's a medical emergency requiring urgent treatment within 6-12 hours to prevent permanent cartilage destruction, with treatment involving emergency surgical drainage and 4-6 weeks of IV antibiotics achieving 70-80% good outcomes if treated promptly, but 25-50% develop permanent joint damage if treatment delayed more than 24 hours.

Severe joint pain that developed over hours to days (acute onset)Inability to move or bear weight on affected joint due to painFever (temperature above 38°C) and feeling generally unwell

Septic Arthritis (Infected Joint - Medical Emergency)

Bacterial joint infection requiring urgent drainage and antibiotics within 24-48 hours - delays cause irreversible cartilage destruction, secondary arthritis in 30-50%

Severe joint pain, swelling, warmth - refuse to move or bear weight (hallmark septic arthritis)Fever and chills (systemic infection - 60-80% patients, but absence does not rule out septic arthritis)Joint held in flexed position of comfort (extension painful - stretches inflamed capsule)

Sinding-Larsen-Johansson Syndrome (Kneecap Growth Plate Pain)

Sinding-Larsen-Johansson syndrome is a growth-related overuse condition affecting the bottom of the kneecap (patella) in active adolescents aged 10-14 years - it causes localized pain and tenderness at the inferior pole of the patella from repetitive jumping and running activities causing inflammation where the patellar tendon attaches to the growing kneecap, typically resolving completely with activity modification and physiotherapy within 3-6 months as the growth plate matures.

Localized pain at bottom tip of kneecap (inferior pole), worsening with jumping and runningTenderness when pressing directly on bottom of kneecapPain kneeling or doing activities requiring knee flexion (squats, stairs)

Bowlegs (Blount's Disease / Tibia Vara)

Tibia vara (Blount's disease) is abnormal bowing of the lower legs caused by growth disturbance in the inner (medial) part of the shin bone's growth plate near the knee - differs from normal physiologic bowing in toddlers by being progressive, asymmetric, and not self-correcting - infantile form (develops before age 3) most common in obese early walkers, often responds to bracing if caught early but may require surgery to correct severe deformity - adolescent form (age 8-15) almost always requires corrective osteotomy surgery (cutting and realigning bone) as bracing ineffective - untreated leads to progressive bowleg deformity, knee arthritis, and walking difficulties

Progressive bowing of one or both lower legs (shin bones curve outward creating bowleg appearance)Asymmetric bowing (one leg more bowed than the other in unilateral cases)Limping or waddling gait (especially bilateral cases)

Upper Back

Ankle

Ankle Arthritis

Ankle arthritis causes pain and stiffness in your ankle joint. Learn about symptoms, treatment options from braces to ankle fusion or replacement, and how to manage ankle pain effectively.

Ankle pain that's worse with activityMorning stiffnessSwelling of the ankle

Ankle Fusion (Arthrodesis)

Ankle fusion permanently joins ankle bones to eliminate painful arthritic joint - gold standard for end-stage ankle arthritis, 90-95% pain relief, 85-90% fusion rate, but eliminates ankle motion and increases stress on adjacent joints

Severe ankle pain with every step despite maximum non-surgical treatment (physiotherapy, injections, bracing)Pain at rest and night pain disrupting sleepStiffness and loss of ankle motion (already stiff arthritic ankle - fusion won't significantly worsen function)

Total Ankle Replacement

Total ankle replacement preserves ankle motion for end-stage arthritis - modern implants show 75-85% survival at 10 years, allows more normal gait than fusion, but higher revision rate and activity restrictions compared to ankle arthrodesis

Severe ankle pain with walking despite maximum conservative treatment failing to provide adequate reliefInability to walk more than 1-2 blocks due to ankle pain and stiffnessDesire to preserve ankle motion and avoid permanent stiffness from ankle fusion

Ankle Dislocations (Emergency)

Ankle dislocation is orthopedic EMERGENCY requiring urgent reduction within 6 hours - 98% associated with fractures, skin necrosis risk within 4-6 hours, neurovascular injury 10-20%, requires immediate reduction then definitive fracture fixation

Obvious severe ankle deformity - ankle joint dislocated out of position, foot in abnormal position relative to legSevere ankle pain and inability to move ankle or bear weightSkin tenting (skin stretched tight over dislocated bones, appearing pale or white) - indicates impending skin necrosis EMERGENCY

Broken Ankle

An ankle fracture (broken ankle) is a break in one or more of the bones that make up your ankle joint. Learn about symptoms, treatment options including surgery, recovery timelines, and when you can return to normal activities.

Immediate severe pain after injuryCannot bear weight on ankleRapid swelling

Calcaneal Tuberosity Fractures (Achilles Avulsion)

Achilles tendon avulsion fracture pulling bone fragment off back of heel - causes inability to push off or stand on toes, nearly always requires surgical repair with tension band wiring or screw fixation

Sudden sharp pain in back of heel at moment of injury (during push-off, jumping, or sudden plantarflexion movement)Inability to push off ground or stand on toes on affected foot (Achilles tendon detached - cannot plantarflex ankle)Palpable gap or defect in Achilles tendon at heel insertion (bone fragment pulled away, tendon no longer attached to calcaneus)

Midfoot Fracture-Dislocations (Chopart Injuries)

Chopart injuries are severe midfoot fracture-dislocations where the bones of your midfoot separate from the ankle bones at two key joints, usually from high-energy trauma like car accidents or falls—these injuries cause severe pain, swelling, and inability to walk, almost always require surgery to realign and stabilize the bones with plates and screws, and typically need 3-6 months of non-weight bearing recovery followed by gradual rehabilitation, with arthritis and stiffness being common long-term complications affecting 50-70% of patients.

Severe midfoot pain and swellingInability to bear weight or walkVisible foot deformity or abnormal position

Chronic Ankle Instability (Recurring Ankle Sprains)

Chronic ankle instability is a condition where your ankle repeatedly 'gives way' or feels unstable, usually developing after one or more severe ankle sprains that didn't heal properly—you may experience your ankle rolling outward frequently (especially on uneven surfaces), swelling and pain after activities, and a constant feeling that your ankle might give out. Most cases improve with 3-6 months of physiotherapy focused on ankle strengthening and balance exercises, but if instability persists despite therapy, surgical ligament reconstruction using your own tissues provides 85-90% success in restoring ankle stability, with most patients returning to sports within 4-6 months after surgery.

Ankle frequently 'gives way' or rolls outward, especially on uneven groundFeeling of ankle instability or lack of confidence in the ankleRecurring ankle sprains (2 or more per year)

High Ankle Sprains (Syndesmotic Injuries)

High ankle sprains (syndesmotic injuries) are tears of the ligaments connecting the tibia and fibula bones above the ankle joint, occurring from external rotation injuries when the foot is planted and the body rotates outward - they account for 10-15% of ankle sprains but are more severe than typical lateral ankle sprains, causing pain above the ankle with walking and weight-bearing, taking 3-6 months to heal versus 4-6 weeks for lateral ankle sprains - treatment depends on stability: stable injuries heal with CAM boot immobilization and protected weight-bearing for 4-6 weeks, while unstable injuries (widening of the tibiofibular joint on weight-bearing X-rays) require surgery with syndesmotic screw or suture button fixation to restore ankle stability.

Pain above ankle (between tibia and fibula bones), not on sides of ankleSevere pain and difficulty weight-bearing or walkingSwelling above ankle and lower leg

Ankle Sprains (Rolled Ankle)

Ankle sprains (rolling your ankle) are the most common sports injury, occurring when you roll your foot inward causing the outer (lateral) ankle ligaments to stretch or tear - most ankle sprains are mild (Grade 1 stretching) or moderate (Grade 2 partial tear) healing fully in 2-6 weeks with RICE treatment (rest, ice, compression, elevation) and physiotherapy, though 10-20% develop chronic ankle instability (repeated sprains, giving way) requiring ligament reconstruction surgery if physiotherapy fails

Pain on outer side of ankle, especially with weight-bearing or twistingSwelling around ankle (mild to severe depending on severity)Bruising around ankle and foot (appears 1-2 days after injury)

Inside Ankle Sprain (Deltoid Ligament Injury)

Medial ankle sprains are injuries to the deltoid ligament—a strong, fan-shaped ligament complex on the inside (medial) side of the ankle connecting the tibia (shin bone) to the talus and calcaneus (ankle bones)—much less common than lateral (outside) ankle sprains, accounting for only 5-10% of all ankle sprains. These injuries typically occur from eversion (ankle rolling outward) or rotational forces, often associated with high-energy trauma (sports injuries, falls) or ankle fractures (deltoid injury with fibula fracture is bimalleolar equivalent fracture requiring surgery). Isolated deltoid sprains present with inside ankle pain, swelling, and difficulty bearing weight. Most heal with conservative treatment (boot immobilization, physiotherapy) over 6-8 weeks, though severe injuries may require surgery. The deltoid ligament is stronger than lateral ankle ligaments, so medial ankle pain after injury should prompt careful evaluation to rule out fractures or syndesmosis injuries often associated with deltoid tears.

Pain on inside (medial) of ankleSwelling over inside ankle bone (medial malleolus)Tenderness when pressing on deltoid ligament

Peroneal Tendon Tears (Outside Ankle Tendons)

Peroneal tendon injuries involve tears, splits, or subluxation (dislocation) of the two tendons (peroneus longus and brevis) running behind the outside ankle bone (lateral malleolus), which evert the foot (turn sole outward) and stabilize the ankle, most commonly affecting athletes in cutting sports, dancers, and individuals with high-arched (cavus) feet or chronic ankle instability. These injuries range from peroneal tendinitis (inflammation from overuse—20-30% of lateral ankle pain in runners), to longitudinal splits within tendons (peroneus brevis most commonly affected—tears along length of tendon), to complete ruptures, and peroneal subluxation/dislocation (tendons slip out from behind ankle bone during movement due to torn retinaculum—restraining band holding tendons in groove). Patients present with lateral ankle pain, swelling behind outer ankle bone, clicking or snapping sensation (if subluxing), and weakness with foot eversion. Diagnosis requires high clinical suspicion as often misdiagnosed as lateral ankle sprain, with ultrasound or MRI confirming tendon tears, splits, or subluxation. Treatment depends on injury pattern: acute tendinitis managed conservatively with immobilization, physiotherapy, and NSAIDs (70-80% success); chronic tendinosis or partial splits may need 3-4 months conservative management before considering surgery; complete ruptures, large longitudinal splits, and recurrent subluxation typically require surgical repair (debridement of diseased tissue, tubularization of split tendons, groove deepening for subluxation). Surgical outcomes: 75-85% good-to-excellent results with tendon repair/reconstruction, though return to high-level sports takes 6-9 months and recurrence of subluxation occurs in 5-15% despite surgery.

Pain behind and below outside ankle bone (lateral malleolus)Swelling along outside of ankleClicking, popping, or snapping sensation during ankle movement (if subluxing)

Adult Flatfoot (Posterior Tibial Tendon Dysfunction)

Posterior tibial tendon dysfunction (PTTD) is progressive weakening and degeneration of the posterior tibial tendon—the main tendon supporting the arch of the foot—leading to adult-acquired flatfoot deformity, most commonly affecting middle-aged and older women (particularly those with obesity, diabetes, or hypertension). The condition develops when the posterior tibial tendon (running behind inside ankle bone down to midfoot bones) gradually stretches, tears, and fails, causing the foot arch to collapse, the heel to tilt outward (valgus), and the forefoot to turn outward (abduction)—creating a characteristic 'too many toes' sign when viewing foot from behind. PTTD progresses through four stages: Stage I (tendinitis with pain but no deformity), Stage II (flexible flatfoot deformity that can be passively corrected), Stage III (fixed rigid flatfoot that cannot be corrected), and Stage IV (ankle arthritis from altered biomechanics). Patients present with progressive medial ankle and arch pain, difficulty walking on uneven ground, inability to stand on tiptoes on affected foot (single heel raise test), and worsening foot shape over months to years. Treatment is stage-dependent: Stage I managed conservatively with immobilization, orthotics, physiotherapy (80-90% success); Stage II requires orthotic trial but often needs surgical tendon reconstruction and bone realignment procedures (85-90% success with surgery); Stages III-IV require major reconstructive surgery (joint fusions) with 70-80% achieving stable, functional (though stiff) foot. Untreated PTTD progresses inexorably to severe fixed deformity, chronic pain, and disability.

Pain and swelling along inside of ankle and archProgressive flattening of foot arch (may not notice initially)Heel tilting outward when standing

Rigid Flatfoot (Pes Planus)

Rigid flatfoot is a condition where the foot arch remains flat and doesn't restore when standing on tiptoes (unlike flexible flatfoot), most commonly caused by tarsal coalition (abnormal bone or cartilage connection between foot bones) in children ages 8-15, leading to painful flat feet, ankle stiffness, and difficulty with sports - treatment ranges from orthotics and activity modification (60-70% improve) to surgical removal of the coalition or fusion if conservative treatment fails.

Flat foot arch that doesn't restore when standing on tiptoes (rigid deformity)Pain in midfoot or outer ankle during walking or sports (worse on uneven ground)Ankle and foot stiffness, limited ability to turn foot inward and outward

pelvis

Head & Neck

Athletic Groin Pain (Sports Hernia/Athletic Pubalgia)

Comprehensive guide to athletic groin pain - Doha classification, adductor-related groin pain, pubic symphysis dysfunction, FAI differential, Copenhagen protocol, and surgical treatment for orthopaedic exam

Deep groin pain during kicking, sprinting, or sudden direction changesPain with sit-ups or twisting movementsTenderness in the lower abdomen or upper inner thigh

Atlantoaxial Instability

Comprehensive guide to atlantoaxial instability - C1-C2 pathology, Down syndrome association, ADI measurement, surgical stabilization and fusion techniques for orthopaedic exam

Neck pain, especially at the base of the skullLimited or painful neck rotation (difficulty turning head side-to-side)Headaches at the back of the head

Autologous Chondrocyte Implantation (ACI)

Comprehensive guide to autologous chondrocyte implantation and MACI - two-stage cartilage repair, indications, surgical technique, and outcomes for orthopaedic examination

Knee pain with activity (walking, stairs, squatting) that improves with restIntermittent knee swelling after activityClicking, catching, or locking sensation (if loose cartilage flap)

Avascular Necrosis of the Humeral Head

Comprehensive guide to causes, staging, and treatment of humeral head AVN including core decompression, biological treatments, and joint replacement surgery decision-making

Deep shoulder pain that worsens with activity and at nightProgressively worsening pain over months (not sudden onset like rotator cuff tear)Reduced shoulder range of motion, especially overhead activities and external rotation

Calcific Tendinitis of the Shoulder (Calcium Deposits in Rotator Cuff)

Calcium deposits form in rotator cuff tendons causing severe shoulder pain. Affects 3% of adults, peak age 30-50. Most common in supraspinatus tendon. Resorptive phase causes excruciating pain (8-10/10). Often self-limiting over months to years. Treatment includes NSAIDs, barbotage (needle aspiration of calcium), ESWT, corticosteroid injections, or arthroscopic removal if conservative measures fail.

Severe shoulder pain (often sudden onset, excruciating 8-10/10 during resorptive phase)Shoulder stiffness and restricted movement (especially reaching overhead or behind back)Night pain disrupting sleep

DDH Treatment Options (Developmental Dysplasia of the Hip in Babies and Children)

Developmental dysplasia of the hip (DDH) - spectrum from unstable hip to dislocated hip in babies and children. Affects 1-3% of newborns, girls 4-6x more than boys. Universal newborn screening in Australia. Treatment age-dependent: Pavlik harness 0-6 months (95% success), closed reduction and spica cast 6-18 months, open reduction and pelvic osteotomy 18 months-8 years. Early detection and treatment prevents lifelong hip problems and early arthritis.

Asymmetric skin folds or leg creases (one side different from other)Limited hip abduction (hip doesn't spread out as far on one side)Leg length discrepancy (one leg appears shorter)

Iliac Wing Fracture (Duverney Fracture - Broken Pelvic Bone)

Iliac wing fracture (Duverney fracture) - break in wing of pelvic bone from direct trauma. Usually stable injury from motor vehicle side-impact collision, fall from height, or pedestrian struck by vehicle. Most treated non-operatively with pain management and early mobilization. Good prognosis for isolated fractures. Must assess for associated injuries (intra-abdominal bleeding, bladder rupture, other fractures). Recovery 6-12 weeks.

Severe hip and pelvic pain (localized to side of pelvis)Large bruise and swelling over hip and flankInability to walk or bear weight on affected side

Intertrochanteric Hip Fracture (Broken Hip Between Trochanters)

Hip fracture in elderly between greater and lesser trochanter. Second most common hip fracture after femoral neck fractures. Average age 75-80. Caused by low-energy falls. Requires urgent surgery within 24-48 hours (dynamic hip screw or intramedullary nail). Good bone healing but high 1-year mortality 20-30% due to medical complications. Weight-bearing immediately after surgery. Orthogeriatric co-management improves outcomes.

Severe hip or groin pain after fall (unable to bear weight, cannot stand)Shortened and externally rotated leg (leg appears shorter and turned outward)Complete inability to lift leg off bed (cannot do straight leg raise)

Forearm

Broken Forearm (Both Bones)

A both-bone forearm fracture means both the radius and ulna (the two bones in your forearm) are broken. Learn about treatment in children versus adults, surgery with plates, casting, and recovery.

Immediate severe pain after injuryVisible deformity of forearmInability to rotate forearm

Broken Wrist (Distal Radius Fracture)

A distal radius fracture is a break in the wrist bone near your hand - the most common broken bone in adults. Learn about treatment options, recovery time, and what to expect from a broken wrist.

Immediate severe wrist pain after fallRapid swelling of the wristVisible deformity or dinner fork appearance

Wrist Arthritis (Pinky Side of Wrist)

DRUJ arthritis is wear-and-tear or post-injury arthritis affecting the joint where the two forearm bones meet at the wrist (on the pinky side) - this joint allows you to rotate your forearm (turn palm up and down) - arthritis here causes pain on the pinky side of the wrist, difficulty turning doorknobs or using screwdrivers, clicking or grinding with forearm rotation, and swelling - treatment ranges from splints and anti-inflammatory medication to surgery (joint replacement or salvage procedures), with 70-80% achieving good pain relief and functional improvement

Pain on the pinky (little finger) side of the wristDifficulty rotating forearm - turning palm up (supination) or palm down (pronation)Clicking, popping, or grinding sensation with wrist/forearm movement

Broken Forearm in Children (Both-Bone Forearm Fracture)

Forearm fractures are one of the most common broken bones in children (affecting 1 in 25 kids before age 16), usually from falling on an outstretched hand or direct blow during sports or play—causing immediate pain, visible deformity, and inability to move the arm. Most heal excellently with casting alone (4-6 weeks in cast, back to normal activities at 8-10 weeks) because children's bones heal faster than adults and have amazing ability to straighten out crooked healing naturally as the child grows, though some severely displaced or unstable fractures need surgery to realign bones with flexible rods or plates.

Immediate severe pain in forearm after fall or injuryVisible deformity or bend in forearmSwelling and bruising of forearm

Broken Forearm in Adults (Both-Bone Forearm Fracture)

Adult forearm shaft fractures are serious injuries where both forearm bones (radius and ulna) break along their length, usually from high-energy trauma like motor vehicle accidents, falls from height, or direct blows—causing severe pain, visible deformity, and inability to rotate the forearm. Unlike children's forearm fractures which heal well in casts, adult forearm fractures almost always require surgery with plates and screws on both bones (casting alone has 50-60% failure rate with malunion or nonunion) followed by 3-6 months recovery including physiotherapy to regain forearm rotation and strength.

Severe forearm pain after traumaObvious deformity or abnormal bend in forearmSwelling and bruising along entire forearm

Broken Ulna Bone from Direct Blow (Nightstick Fracture)

An isolated ulna fracture, commonly called a nightstick fracture, is a break in the ulna (inner forearm bone) without injury to the radius (outer forearm bone), typically from direct blow to forearm when raising arm to block a strike—causing localized forearm pain, swelling, and difficulty rotating forearm. Unlike both-bone forearm fractures which require surgery, isolated ulna fractures can often be treated non-surgically with casting if minimally displaced (less than 50% displaced or less than 10 degrees angulated), healing in 8-12 weeks with 85-90% good outcomes. Significantly displaced fractures require surgery (plate and screws) because malunion causes permanent loss of forearm rotation and chronic pain affecting daily activities.

Pain along inner forearm after direct blowLocalized swelling and tenderness over ulna boneDifficulty rotating forearm (palm up/palm down)

Wrist Cartilage Tears (TFCC Injuries)

TFCC (triangular fibrocartilage complex) injuries are tears in the cartilage cushion on the small-finger side of the wrist that stabilizes the joint and absorbs impact - commonly occurs from falling on outstretched hand, wrist twist injuries, or degenerative wear-and-tear in people over 40 - causes ulnar-sided (pinky-side) wrist pain with gripping, twisting motions, or weight-bearing through the wrist - many cases heal with 4-6 weeks of splinting and physiotherapy, though chronic tears or unstable injuries may require arthroscopic surgery to repair or debride the torn cartilage, with recovery taking 3-6 months to regain full strength and return to activities

Pain on small-finger (ulnar) side of wrist, worse with gripping or twistingClicking, popping, or catching sensation with wrist movementWeakness of grip strength, difficulty opening jars or turning doorknobs

Upper Arm

Wrist

Carpal Tunnel Syndrome

Carpal tunnel syndrome causes numbness, tingling, and pain in your hand and fingers. It happens when pressure builds up on the nerve in your wrist. Learn about symptoms, treatments, and when surgery might help.

Numbness and tingling in thumb, index, middle, and ring fingersHand pain or achingWeakness in hand grip

Ganglion Cysts (Wrist and Hand Lumps)

Ganglion cysts are benign fluid-filled lumps that develop near joints or tendons, most commonly on the back of the wrist (60-70% of cases) or palm side of the wrist near the radial artery (20%) - they contain thick jelly-like fluid from the joint lining and cause a visible bump that may be painless or cause aching with wrist motion - ganglion cysts are completely harmless (not cancer) and resolve spontaneously without treatment in 40-60% of cases over several years, though symptomatic cysts can be treated with aspiration (draining with needle - 30-50% recurrence) or surgical excision (10-20% recurrence).

Visible lump or bump on wrist or hand (may vary in size)Aching pain with wrist motion or grip (especially if cyst large)Lump that becomes more prominent with wrist flexion or extension

Broken Hamate Bone (Wrist Fracture in Athletes)

Hamate fractures are breaks in a small wrist bone (hamate) with a prominent hook projection, most commonly occurring as hook of hamate fractures in baseball batters, golfers, and racquet sport players from repetitive trauma when bat or club strikes the palm—causing ulnar-sided wrist pain, weak grip, and often misdiagnosed as wrist sprain for weeks or months. Standard X-rays frequently miss these fractures, requiring CT scan for diagnosis. Treatment options include casting (which has 50-60% failure rate due to poor blood supply to hook) or surgical removal of the broken hook piece (excision arthroplasty), which relieves pain immediately and doesn't affect wrist function, making it the preferred treatment for most athletes.

Pain on ulnar (little finger) side of wrist, in palmWeak grip strength, difficulty holding bat or clubPain worsened by gripping or swinging bat/club/racquet

Kienböck's Disease (Lunate Avascular Necrosis)

Kienböck's disease is avascular necrosis (bone death from loss of blood supply) of the lunate, one of eight small carpal bones in the wrist - it typically affects young adults aged 20-40 years, especially manual laborers, causing progressive wrist pain, stiffness, and weakness over months to years - the lunate bone gradually collapses causing wrist arthritis if untreated - treatment depends on Lichtman staging (I-IV): early stages (I-II) may respond to immobilization or joint-leveling procedures (radial shortening or ulnar lengthening osteotomy) unloading the lunate and allowing revascularization in 50-60% of cases, while advanced stages (III-IV) with lunate collapse and arthritis require salvage procedures (proximal row carpectomy or wrist fusion) sacrificing wrist motion for pain relief.

Wrist pain (dorsal/central wrist), gradually worsening over monthsWrist stiffness and loss of motion (especially extension)Weak grip strength and difficulty with forceful gripping

Psoriatic Arthritis in the Hand

Psoriatic arthritis affecting the hands causes painful swollen joints (especially finger joints), sausage-like swelling of entire digits (dactylitis), nail pitting and changes, and joint destruction in about 30% of people with skin psoriasis - unlike rheumatoid arthritis which affects knuckles symmetrically, psoriatic arthritis often affects the finger tip joints (DIP joints) asymmetrically and can cause severe deformities if untreated, requiring early treatment with disease-modifying medications to prevent permanent joint damage.

Painful swollen finger or thumb joints, especially the joints closest to fingernails (DIP joints—unlike rheumatoid arthritis)Sausage digits (dactylitis)—entire finger or toe swollen like a sausage, not just the jointNail changes (pitting, ridges, separation from nail bed, thickening, discoloration)

Scaphoid Fracture Surgery

Scaphoid fractures are breaks in a small boat-shaped bone in your wrist near the base of your thumb - they commonly occur from falling onto an outstretched hand and are tricky because they often don't show up on initial X-rays and have poor blood supply - most scaphoid fractures heal in a cast over 8-12 weeks, but surgery with a small screw is needed for displaced fractures (moved out of position), fractures not healing in a cast, or fractures in athletes who need faster return to sport

Pain at base of thumb, especially with gripping or wrist movementTenderness in 'anatomical snuffbox' (hollow area at base of thumb)Swelling around wrist and thumb base

Scaphoid Fractures (Wrist Fracture)

Scaphoid fractures are breaks in a small boat-shaped bone in the wrist near the base of the thumb, commonly caused by falling onto an outstretched hand - they're tricky because they often don't show on initial X-rays and have poor blood supply making them slow to heal, with treatment ranging from cast immobilization for 8-12 weeks to surgical screw fixation for displaced fractures or non-healing cases.

Pain and tenderness in the 'anatomical snuffbox' (hollow at base of thumb when thumb extended)Wrist pain worsening with gripping or twisting motionsSwelling on thumb side of wrist (may be subtle initially)

Scaphoid Nonunion (Non-Healing Wrist Fracture)

Scaphoid nonunion occurs when a scaphoid wrist fracture fails to heal after 3-4 months of treatment, affecting 5-10% of scaphoid fractures - it causes persistent wrist pain, weakness, and leads to early wrist arthritis within 5-10 years if untreated, requiring surgical bone grafting and screw fixation with 80-90% success rate in achieving healing and preventing arthritis progression.

Persistent wrist pain on thumb side lasting more than 3-4 months after injuryPain and weakness with gripping, twisting, or weight-bearing through wristAnatomical snuffbox tenderness (pain in hollow at base of thumb)

Thumb Base Fractures (Bennett and Rolando Fractures)

Thumb base fractures (Bennett and Rolando fractures) are breaks at the bottom of the thumb metacarpal bone where it forms the critical saddle joint with the wrist - Bennett fractures (most common) are diagonal breaks involving the joint surface with a small fragment held in place by ligament while main bone fragment is pulled out of position by thumb muscle, typically from punching or fall onto bent thumb - because the fracture disrupts the thumb joint and is unstable, most require surgery with pins or screws to restore alignment and prevent long-term arthritis - recovery takes 6-12 weeks in a cast/splint with gradual return to full strength over 3-4 months

Pain at base of thumb near wrist, worsens with thumb movement or grippingSwelling and bruising at base of thumb and thenar eminence (thumb muscle pad)Difficulty or inability to pinch or grasp objects

Ulnar-Sided Wrist Pain (Ulnar Impaction Syndrome)

Ulnar impaction syndrome occurs when the ulna bone (forearm bone on pinky side) is too long relative to the radius bone, causing excessive pressure on the ulnar side of the wrist - this leads to pain on the pinky side of the wrist, worse with gripping, twisting, and leaning on the hand - the extra-long ulna damages the triangular fibrocartilage (TFCC) and wrist cartilage over time - conservative treatment (activity modification, wrist splinting, corticosteroid injections) provides temporary relief in 30-50% of patients, while persistent symptoms are treated with surgery to shorten the ulna bone (ulnar shortening osteotomy) achieving 80-85% good outcomes.

Pain on pinky side of wrist, worse with gripping and twisting motionsClicking, popping, or grinding sensation in wrist with rotationWeak grip strength, difficulty with forceful activities

Lower Back

Elbow

Coronoid Fracture (Elbow Bone Break)

A coronoid fracture is a break of the coronoid process at the front of the elbow. Learn about causes, the terrible triad injury, surgery with plates or screws, and recovery from this elbow injury.

Immediate severe elbow pain after injuryInability to bend or straighten elbowElbow instability or feeling like it gives way

Cubital Tunnel Syndrome (Ulnar Nerve Compression at Elbow)

Cubital tunnel syndrome is compression of the ulnar nerve as it passes behind the inner elbow bone (medial epicondyle) in the cubital tunnel - it is the second most common nerve compression syndrome after carpal tunnel, causing numbness and tingling in the ring and small fingers, hand weakness, and clumsiness with fine motor tasks - symptoms typically worsen with prolonged elbow flexion (talking on phone, sleeping with bent elbow) and improve with conservative treatment (night splinting, avoiding pressure on elbow) in 50-60% of mild cases, while moderate-severe cases often require surgery which achieves 80-90% improvement if performed before permanent nerve damage occurs.

Numbness and tingling in ring and small fingers (especially small finger side)Hand weakness, difficulty pinching and gripping objectsClumsiness with fine motor tasks (buttoning, typing, writing)

Biceps Tendon Tear at the Elbow

A distal biceps rupture occurs when the biceps tendon tears completely off the bone at your elbow, usually from sudden forceful straightening while lifting something heavy—you'll feel a sharp pop in the front of your elbow with immediate pain, bruising, and a visible bulge in your upper arm where the biceps muscle bunches up. Most active people choose surgical reattachment within 2-4 weeks for best results (restoring 95% of strength), while non-surgical treatment leaves permanent 30-40% loss of arm twisting strength and endurance, making surgery the preferred option for people under 60 who want full arm function.

Sharp pop or tearing sensation in front of elbow during liftingSudden pain in front of elbow and upper armVisible bulge in upper arm (muscle bunched up, 'Popeye deformity')

Elbow Arthritis (Worn Elbow Joint)

Elbow arthritis causes pain and stiffness from worn cartilage. Learn about post-traumatic arthritis, rheumatoid arthritis, treatment options, cortisone injections, and when elbow replacement might help.

Elbow pain with movementLoss of motion - cannot fully straighten or bend elbowGrinding, clicking, or catching sensation

Dislocated Elbow

An elbow dislocation occurs when the bones of your forearm separate from your upper arm bone. Learn about simple versus complex dislocations, treatment, and recovery expectations.

Severe elbow pain after injuryObvious deformity of elbowCannot move elbow

Broken Outside Elbow Bone in Children (Lateral Condyle Fracture)

Lateral condyle fractures are breaks in the outside knob of the elbow bone (humerus) in children, the second most common pediatric elbow fracture after supracondylar fractures, typically from fall onto outstretched arm causing elbow to buckle inward—presenting with outside elbow pain, swelling, and difficulty straightening arm. These fractures are tricky because they involve the growth plate and joint surface, with high risk of nonunion (failure to heal) or malunion (crooked healing) causing permanent elbow deformity if undertreated. Minimally displaced fractures (less than 2mm) can be treated with casting, but any displacement greater than 2mm requires surgery (pins or screws) to prevent complications, with 85-90% excellent outcomes when treated appropriately but 30-40% complication rate if treatment inadequate.

Pain on outside of elbow after fallSwelling around elbow, especially on outsideDifficulty straightening elbow fully

Tennis Elbow (Lateral Epicondylitis)

Tennis elbow causes pain on the outer elbow from overuse. Learn about physiotherapy, braces, injections, and surgery options. Most people recover without surgery.

Pain on outer side of elbowPain with gripping and liftingWeak grip strength

Golfer's Elbow (Medial Epicondylitis)

Golfer's elbow causes pain on the inner elbow from overuse. Learn about physiotherapy, injections, when to check for nerve problems, and treatment options.

Pain on inner side of elbowPain with gripping and wrist bendingWeak grip

Olecranon Fractures (Elbow Point Fracture)

Fracture of elbow point bone from direct fall - nearly always requires tension band wiring or plate fixation surgery to restore triceps function and elbow extension

Severe elbow pain immediately after direct fall onto point of elbowInability to straighten elbow (extend against gravity) - triceps muscle pulls fragment away from ulnaPalpable gap or defect at back of elbow where olecranon fractured (bone fragment separated)

Pronator Syndrome (Median Nerve Compression at Elbow)

Pronator syndrome is compression of the median nerve in the upper forearm near the elbow, causing forearm pain, thumb/index/middle finger numbness, and hand weakness that mimics carpal tunnel syndrome but with key differences—pain worsens with repetitive gripping and forearm pronation (rotating palm down), and symptoms extend to the forearm and palm unlike carpal tunnel which spares the palm and causes nocturnal symptoms. The median nerve can be compressed at four potential sites in the proximal forearm: ligament of Struthers (uncommon bony abnormality 1cm above elbow), lacertus fibrosus (fascial band from biceps tendon), between the two heads of pronator teres muscle (most common site 60-70%), or beneath the fibrous arch of flexor digitorum superficialis (FDS). Diagnosis is clinical with provocative tests (resisted pronation reproducing symptoms, tenderness over pronator teres) and nerve conduction studies showing focal slowing. Treatment is initially conservative with activity modification, NSAIDs, splinting, and physiotherapy achieving success in 50-70% of mild cases, while surgical decompression (releasing all four potential compression sites) is reserved for failed conservative treatment or severe cases with motor weakness, achieving 80-85% good-excellent outcomes with 3-6 month recovery.

Aching forearm pain that worsens with repetitive gripping, forearm pronation (turning palm down), or sustained flexed elbow positionNumbness and tingling in thumb, index finger, middle finger, and radial half of ring finger (median nerve distribution) including the palm (key difference from carpal tunnel syndrome which spares palm)Hand weakness—difficulty pinching (thumb opposition weak), buttoning shirts, opening jars, reduced grip strength

Radial Head Dislocations (Elbow Dislocation in Children)

Radial head dislocations occur when the radial bone at the elbow slips out of position, most commonly seen as 'nursemaid's elbow' in young children (ages 1-4) when the arm is pulled suddenly, causing immediate pain and refusal to use the arm - treatment involves a quick reduction maneuver that provides instant relief in 90-95% of cases, though some dislocations are associated with forearm fractures (Monteggia injury) requiring surgery.

Sudden refusal to use or move the affected arm after pulling or yankingChild holds arm slightly bent and close to body, palm facing downPain when trying to move elbow or rotate forearm (turning palm up)

Radial Head Fracture (Elbow Fracture)

A radial head fracture is a break in the knobby top of the radius bone at the elbow. Usually caused by falling on an outstretched hand, most heal without surgery but some complex fractures need repair or replacement.

Elbow pain on outer sideSwelling around elbowDifficulty bending or straightening elbow

Radial Neck Fractures in Children (Elbow Fracture)

Radial neck fractures are breaks just below the radial head bone at the elbow in children ages 4-10, typically caused by falling onto an outstretched hand, resulting in elbow pain, swelling, and difficulty straightening the arm - most minimally angulated fractures (less than 30 degrees tilt) heal well with casting alone in 4-6 weeks, while severely tilted fractures may require manipulation or surgery to prevent permanent elbow stiffness.

Elbow pain and tenderness on outer side of elbow (over radial head)Swelling around elbow joint within 2-4 hours of injuryDifficulty or pain when trying to straighten elbow fully

Radial Tunnel Syndrome (Forearm Nerve Compression)

Radial tunnel syndrome is compression of the radial nerve in the forearm causing deep aching pain on the outer (thumb) side of the forearm and elbow, often mimicking tennis elbow but without weakness - it results from repetitive gripping or twisting activities and typically improves with 3-6 months of rest, activity modification, and physiotherapy, though 10-20% of cases may require surgical nerve decompression if conservative treatment fails.

Deep, aching pain on outer forearm 3-4cm below elbow (different from tennis elbow surface pain)Pain worsens with repetitive gripping, twisting motions (turning screwdriver, doorknob)Tenderness when pressing on outer forearm muscles (not on elbow bone like tennis elbow)

Hand

Deep Hand Infections (Space Infections)

Deep space hand infections are serious bacterial infections in the closed compartments deep within your hand, usually from puncture wounds, bites, or spread from finger infections—they cause severe pain, swelling, inability to move fingers, and require emergency surgical drainage in the operating theatre plus IV antibiotics to prevent permanent hand damage, with most patients hospitalized for 3-7 days and needing 4-8 weeks of hand therapy recovery.

Severe throbbing hand pain, worsening rapidlySwelling of palm or back of handInability to move fingers due to pain

Dupuytren's Contracture

Dupuytren's contracture causes fingers to bend into the palm and not straighten. Learn about this progressive hand condition, when to consider treatment, and options from needle release to surgery.

Lumps or nodules in palmPits or dimples in palm skinThick cords in palm

Extensor Tendon Injuries (Hand & Finger)

Extensor tendon injuries occur when the tendons on the back of your hand or fingers that straighten your fingers are cut or torn—commonly from lacerations, crush injuries, or jamming injuries—causing inability to straighten the affected finger. Treatment depends on location: simple cuts over knuckles can be splinted for 6 weeks with 90% success, but injuries at the fingertip (mallet finger) or middle joint (boutonniere) often leave permanent stiffness even with treatment, and deep cuts usually require surgical repair followed by 8-12 weeks of hand therapy.

Inability to straighten finger or thumb at specific jointDrooping fingertip (mallet finger) or bent middle jointPain and swelling at injury site

Dislocated Finger (Jammed Finger)

A dislocated finger happens when a finger joint pops out of place. Learn about PIP and DIP dislocations, buddy taping, when surgery is needed, and recovery timeline.

Visible deformity of the fingerSevere pain at the jointInability to move the finger

Cut Flexor Tendon (Hand/Finger Tendon Injury)

A cut flexor tendon prevents you from bending your fingers. Learn about emergency treatment, tendon repair surgery, Zone 2 'no man's land' injury, hand therapy protocol, and recovery.

Unable to bend finger at one or more jointsDeep cut on palm of hand or palm-side of fingerBleeding from laceration

Finger Tendon Sheath Infection (Flexor Tenosynovitis)

Flexor tenosynovitis is a serious bacterial infection inside the protective sheath surrounding the flexor tendons in your finger (the tendons that bend your finger)—usually from puncture wounds, bites, or spread from nail infections—causing severe throbbing pain, swelling of the entire finger like a sausage, inability to straighten the finger due to pain, and requires emergency surgery within 24 hours to drain the infection and save the tendon, as delays can cause permanent tendon death and finger stiffness even with treatment.

Severe throbbing pain in entire finger, rapidly worseningFinger swollen along entire length (fusiform 'sausage finger' swelling)Finger held in slightly bent position, unable to straighten due to excruciating pain

Skier's Thumb (Gamekeeper's Thumb)

Gamekeeper's thumb, more commonly called skier's thumb, is a tear or rupture of the ulnar collateral ligament on the inner side of your thumb base, usually from falling onto an outstretched thumb (classic skiing injury when thumb gets caught in pole strap) or ball forcefully bending thumb outward—causing immediate pain, swelling, and weak pinch grip. Partial tears can heal with 4-6 weeks in a thumb spica cast, but complete tears (especially Stener lesions where the torn ligament flips over and can't heal on its own) require surgery to reattach the ligament within 2-3 weeks, otherwise leading to chronic thumb instability, weak pinch strength, and early arthritis if left untreated.

Pain at base of thumb on palm side near webspaceSwelling and bruising at thumb baseWeak pinch grip (difficulty holding objects between thumb and fingers)

Glomus Tumor (Fingernail Tumor Causing Severe Pain)

A glomus tumor is a small benign (non-cancerous) vascular tumor, most commonly occurring under the fingernail (subungual), causing a classic triad of symptoms: severe localized pinpoint pain, extreme sensitivity to cold (touching cold objects causes excruciating pain), and exquisite point tenderness when pressing on the affected spot. Despite being tiny (usually 2-5mm), these tumors cause disproportionate pain that often disrupts sleep and significantly affects quality of life, sometimes for years before diagnosis. Treatment is surgical removal of the tumor, which is curative in 90%+ of cases with immediate pain relief, though 10-15% recur if tumor not completely excised.

Severe localized pain in fingertip or under nail (out of proportion to visible findings)Extreme sensitivity to cold (touching cold water, refrigerator, or objects causes severe pain)Exquisite point tenderness when pressing on specific spot (Love's sign)

Finger Cyst from Arthritis (Mucous Cyst)

Mucous cysts (digital mucoid cysts) are small, fluid-filled bumps that develop on the finger (or rarely toe) near the fingernail, arising from the DIP (distal interphalangeal) joint—the joint closest to the fingertip—typically in people over 50 years with underlying finger arthritis. These cysts appear as translucent, dome-shaped lumps 3-10mm in size, filled with clear, jelly-like fluid (synovial fluid and mucin from the arthritic joint), and commonly cause nail deformity (groove running down nail if cyst presses on nail bed). While benign and not dangerous, they can be cosmetically bothersome or occasionally rupture and become infected. Treatment options range from observation (many patients tolerate them) to aspiration (temporary relief, 50-70% recurrence) to surgical excision with removal of underlying bone spur (90% cure rate but requires minor surgery under local anaesthetic).

Visible bump or lump on finger near nail (most common on index or middle finger)Translucent or clear appearance when light shone through cystNail deformity (groove or ridge running down nail)

Arthritis of the Middle Finger Joints

PIP (proximal interphalangeal) joint arthritis is wear-and-tear arthritis affecting the middle knuckle joints of the fingers - it causes pain, stiffness, swelling, and bony lumps (Bouchard's nodes) making it difficult to bend fingers or grip objects - most common in people over 50 years old, especially women - conservative treatment (splinting, anti-inflammatory medication, corticosteroid injections) manages symptoms in 60-70% of patients, while severe arthritis limiting hand function can be treated with surgery (joint replacement preserving motion or fusion eliminating motion but providing pain relief and stability).

Pain in middle finger joints, worse with gripping or pinchingStiffness of fingers, especially in the morning or after restBony lumps on sides of finger joints (Bouchard's nodes)

Thumb Arthritis (Base of Thumb)

Thumb arthritis at the base of your thumb causes pain with gripping and pinching. Learn about symptoms, splinting, injections, and surgical options to relieve thumb pain.

Pain at the base of the thumbWeakness in grip and pinchVisible bump at base of thumb

Trigger Finger

Trigger finger causes your finger to catch or lock when you bend it. Learn about symptoms, steroid injections, and surgical release to restore smooth finger movement.

Finger catching or lockingPainful clicking or poppingStiffness in the finger

Thigh

Thigh Bone Fractures Near the Knee

Distal femur fractures are breaks in the thighbone just above the knee joint, commonly occurring from high-energy trauma (car accidents, falls from height) in young people or low-energy falls in older adults with osteoporosis - these fractures cause severe knee pain, swelling, inability to bear weight, and visible deformity - most require surgery with metal plates, screws, or rods to realign and stabilize the bone, with recovery taking 3-6 months and good outcomes in 75-85% of patients achieving return to walking and daily activities

Severe pain in the thigh just above the kneeInability to bear weight or stand on the legVisible deformity or abnormal leg position

Limb Lengthening (Distraction Osteogenesis)

Surgical technique to lengthen bones or correct deformities by gradually pulling apart cut bone, stimulating new bone formation through controlled mechanical tension - used for limb length discrepancies, short stature, and bone defects

Limb length discrepancy (one leg or arm shorter than the other) affecting gait, posture, or functionShort stature from skeletal dysplasia or growth plate injuryBone defect after trauma, infection, or tumor resection

Blood Clots in the Leg (Deep Vein Thrombosis)

Deep vein thrombosis (DVT) is a blood clot forming in the deep veins of the leg, commonly occurring after surgery, prolonged immobility, or injury - DVT causes calf pain, swelling, warmth, and redness in one leg - the main danger is the clot breaking off and traveling to the lungs (pulmonary embolism), which can be life-threatening - diagnosis involves ultrasound scanning of leg veins - treatment requires blood-thinning medications for 3-6 months, with 90-95% of patients recovering fully without long-term complications if treated promptly

Calf pain or tenderness, often described as cramping or achingSwelling in one leg (not both) - leg may feel tight or heavyWarmth in the affected leg

Hamstring Injuries

Hamstring injuries cause sudden pain in the back of your thigh, usually during running or sprinting. Learn about grades of hamstring strains, treatment from rest to surgery, and how to prevent re-injury.

Sudden sharp pain in back of thighBruising down the back of thighWeakness bending the knee

Bone Growing in Muscle After Injury (Myositis Ossificans)

Myositis ossificans is a condition where bone forms inside muscle tissue after a direct blow or injury - it most commonly occurs in the thigh (quadriceps) or upper arm (brachialis) muscles after a hard impact, creating a painful lump that gradually hardens as bone develops over weeks to months - the key to treatment is recognizing it early and avoiding aggressive massage, stretching, or early surgery which make it worse - conservative treatment (rest, gentle motion, anti-inflammatory medication) allows the bone to mature over 6-12 months, after which it can be surgically removed if causing problems, achieving 70-80% good outcomes.

Painful lump in muscle 2-4 weeks after direct blow or injuryDecreased range of motion in nearby joint (knee, elbow)Firm, tender mass that gradually hardens over weeks

Quadriceps Contusion (Cork Thigh / Dead Leg)

Bruised thigh muscle from direct impact causing pain, swelling, and difficulty walking. Learn about mild/moderate/severe grading, myositis ossificans risk, treatment protocols, and safe return to sport after a cork thigh.

Immediate pain from direct blow to thighSwelling and bruising of thighDifficulty walking or running

Quadriceps Tendinitis (Jumper's Knee at Thigh)

Quadriceps tendinitis causes pain above the kneecap where the powerful thigh muscle attaches. Common in jumping athletes and runners, it responds well to physiotherapy and gradual activity modification.

Pain above kneecapMorning stiffnessPain with loaded knee extension

Quadriceps Tendon Rupture (Torn Quad Tendon)

A complete tear of the quadriceps tendon above the kneecap, requiring urgent surgical repair. Learn about symptoms, surgery, and the 6-9 month recovery process.

Sudden 'pop' or tearing sensation above kneecapImmediate severe pain above kneecapInability to straighten knee or stand

all-bones

spine

chest

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